Provider Demographics
NPI:1346823226
Name:KEVIN HORVATH MD, LLC
Entity Type:Organization
Organization Name:KEVIN HORVATH MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BILLI
Authorized Official - Middle Name:
Authorized Official - Last Name:BUKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-454-0543
Mailing Address - Street 1:69 N DIXIE DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-2060
Mailing Address - Country:US
Mailing Address - Phone:937-454-0543
Mailing Address - Fax:937-454-2236
Practice Address - Street 1:69 N DIXIE DR
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-2060
Practice Address - Country:US
Practice Address - Phone:937-454-0543
Practice Address - Fax:937-454-2236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty