Provider Demographics
NPI:1235316274
Name:BENION S. HORTON, MD, PC
Entity Type:Organization
Organization Name:BENION S. HORTON, MD, PC
Other - Org Name:NORTHWEST CAROLINA WOMEN'S CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENION
Authorized Official - Middle Name:S
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-667-2232
Mailing Address - Street 1:PO BOX 758
Mailing Address - Street 2:
Mailing Address - City:NORTH WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-0758
Mailing Address - Country:US
Mailing Address - Phone:336-667-2232
Mailing Address - Fax:336-667-2235
Practice Address - Street 1:1405 WILLOW LANE
Practice Address - Street 2:
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659
Practice Address - Country:US
Practice Address - Phone:336-667-2232
Practice Address - Fax:336-667-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500203207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5900153Medicaid
NCH21639Medicare UPIN
NC5900153Medicaid