Provider Demographics
NPI:1225065451
Name:HORTON, JOSEPH A (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:HORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 BANEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-6402
Mailing Address - Country:US
Mailing Address - Phone:205-444-9648
Mailing Address - Fax:
Practice Address - Street 1:1214 COOLIDGE BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2621
Practice Address - Country:US
Practice Address - Phone:337-289-7991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL227272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009986425Medicaid
AL051534543OtherBLUE CROSS
AL009936933Medicaid
AL010033CB65475OtherSECTION 1011
AL300118893OtherRAILROAD MEDICARE
MS00124500OtherMISSISSIPPI MEDICAID
AL051512023OtherBLUE CROSS
LA1451771OtherEMERGENCY LA MEDICAID
LA54854OtherPTAN
AL000021009Medicaid
AL009975860Medicaid
AL051505918OtherBLUE CROSS
AL051526884OtherBLUE CROSS
AL051505826OtherBLUE CROSS
AL051505918Medicaid
AL000021009OtherBLUE CROSS
AL051505918OtherBLUE CROSS
AL010033CB65475OtherSECTION 1011