Provider Demographics
NPI:1235126020
Name:HORTIN, JANET (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:
Last Name:HORTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 STADIUM MALL DR
Mailing Address - Street 2:
Mailing Address - City:WEST LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47907-2052
Mailing Address - Country:US
Mailing Address - Phone:765-418-8433
Mailing Address - Fax:765-496-1227
Practice Address - Street 1:601 STADIUM MALL DR
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47907-2052
Practice Address - Country:US
Practice Address - Phone:765-418-8433
Practice Address - Fax:765-496-1227
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC158807207R00000X
IN01035982A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
92627OtherGEISINGER HEALTH PLAN
000000204059OtherANTHEM BLUE CROSS BLUE SH