Provider Demographics
NPI:1689798613
Name:HORWITZ, GREGORY JAMES (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:JAMES
Last Name:HORWITZ
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 1:1950 DIAMOND PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-4321
Mailing Address - Country:US
Mailing Address - Phone:816-842-8717
Mailing Address - Fax:
Practice Address - Street 1:1950 DIAMOND PKWY STE 200
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-4321
Practice Address - Country:US
Practice Address - Phone:816-842-6717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS33000208800000X
MO2008004272208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO41567017OtherBCBS KC
MO41567017OtherBCBS KC
MOJ71A00001Medicare PIN