Provider Demographics
NPI:1225145840
Name:HORNER-IBLER, BARBARA A (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:HORNER-IBLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19035 W CAPITOL DR
Mailing Address - Street 2:STE 101
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-2755
Mailing Address - Country:US
Mailing Address - Phone:262-754-1421
Mailing Address - Fax:262-754-3760
Practice Address - Street 1:19035 W CAPITOL DR
Practice Address - Street 2:#101
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-2755
Practice Address - Country:US
Practice Address - Phone:262-754-1421
Practice Address - Fax:262-754-3760
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI42553207R00000X
WI204-121207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34173200Medicaid
WI34173200Medicaid