Provider Demographics
NPI:1609835719
Name:HORTON, HEATHER L (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:HORTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KINGS CT
Mailing Address - Street 2:
Mailing Address - City:LANDENBERG
Mailing Address - State:PA
Mailing Address - Zip Code:19350-9324
Mailing Address - Country:US
Mailing Address - Phone:610-274-8946
Mailing Address - Fax:
Practice Address - Street 1:207 N BROAD ST FL 3
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-1500
Practice Address - Country:US
Practice Address - Phone:267-479-4142
Practice Address - Fax:215-463-3820
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048718L207RC0000X, 207RI0011X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015949670013Medicaid
OH4191001Medicare PIN
OH2687767Medicaid