Provider Demographics
NPI:1629069117
Name:HOROWITCH, ALAN R (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:R
Last Name:HOROWITCH
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:PO BOX 5353
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-5353
Mailing Address - Country:US
Mailing Address - Phone:928-344-0466
Mailing Address - Fax:928-341-0503
Practice Address - Street 1:1763 W 24TH ST
Practice Address - Street 2:102
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6219
Practice Address - Country:US
Practice Address - Phone:928-344-0466
Practice Address - Fax:928-341-0503
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZA21691174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1629069117OtherNPI
AZA21691OtherSTATE LICENSE
AZ377988Medicaid
AZA21691OtherSTATE LICENSE
AZ377988Medicaid