Provider Demographics
NPI:1578651287
Name:HORAK, RICHARD L II (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:L
Last Name:HORAK
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:890 N DEAN RD STE 500
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-9454
Mailing Address - Country:US
Mailing Address - Phone:334-821-2708
Mailing Address - Fax:334-821-3309
Practice Address - Street 1:890 N DEAN RD STE 500
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-9454
Practice Address - Country:US
Practice Address - Phone:334-821-2708
Practice Address - Fax:334-821-3309
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.26959207RS0010X
AL26959207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009933381Medicaid
ALP01296630OtherPTAN
ALP01296630OtherPTAN
AL009933381Medicaid