Provider Demographics
NPI:1376640953
Name:HORWITZ, RAY (DO)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 HAMMOND DR NE
Mailing Address - Street 2:BUILDING ONE, SUITE 730
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5529
Mailing Address - Country:US
Mailing Address - Phone:770-394-5050
Mailing Address - Fax:770-730-0998
Practice Address - Street 1:990 HAMMOND DR NE
Practice Address - Street 2:BUILDING ONE, SUITE 730
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5529
Practice Address - Country:US
Practice Address - Phone:770-394-5050
Practice Address - Fax:770-730-0998
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0385132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00682899CMedicaid
GA00682899DMedicaid
GAF59494Medicare UPIN
GA00682899CMedicaid
GA00682899DMedicaid