Provider Demographics
NPI:1225342025
Name:HORTON, ELIZABETH ANN CHERRY (DPM)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN CHERRY
Last Name:HORTON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:CHERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1212 S PARK ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-5600
Mailing Address - Country:US
Mailing Address - Phone:269-344-0874
Mailing Address - Fax:269-344-7256
Practice Address - Street 1:1212 S PARK ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-5600
Practice Address - Country:US
Practice Address - Phone:269-344-0874
Practice Address - Fax:269-344-7256
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5901002469213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOM15760-006Medicare PIN