Provider Demographics
NPI:1588628010
Name:LEJEUNE, HORACE BALTZER (MD)
Entity Type:Individual
Prefix:DR
First Name:HORACE
Middle Name:BALTZER
Last Name:LEJEUNE
Suffix:
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 1:833 SAINT VINCENTS DR
Mailing Address - Street 2:STE 402
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1613
Mailing Address - Country:US
Mailing Address - Phone:205-933-9277
Mailing Address - Fax:205-212-3544
Practice Address - Street 1:2700 10TH AVE S
Practice Address - Street 2:SUITE 502
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1200
Practice Address - Country:US
Practice Address - Phone:205-933-2952
Practice Address - Fax:205-933-5893
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00020807207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529102220Medicaid
AL000032702Medicare ID - Type Unspecified
AL529102220Medicaid