Provider Demographics
NPI:1619234689
Name:HORINGER, JOHN WILLIAM JR (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:WILLIAM
Last Name:HORINGER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:36100 EUCLID AVE 210
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4427
Mailing Address - Country:US
Mailing Address - Phone:440-602-6770
Mailing Address - Fax:440-975-0208
Practice Address - Street 1:36100 EUCLID AVE STE 240
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4427
Practice Address - Country:US
Practice Address - Phone:440-602-6770
Practice Address - Fax:440-975-0208
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.126153207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0121829Medicaid
OHH377890Medicare PIN