Provider Demographics
NPI:1740922871
Name:HORTON, BENJAMIN JORDAN
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:JORDAN
Last Name:HORTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 E JOHNSON AVE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-8413
Mailing Address - Country:US
Mailing Address - Phone:870-936-0254
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD # MS 1028
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8413
Practice Address - Country:US
Practice Address - Phone:913-588-6035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-09
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-12110207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease