Provider Demographics
NPI:1881639839
Name:HORTON, JAMES L JR (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:HORTON
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7169 KALAMAZOO AVE SE STE 100
Mailing Address - Street 2:
Mailing Address - City:CALEDONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49316-8146
Mailing Address - Country:US
Mailing Address - Phone:616-266-9100
Mailing Address - Fax:616-266-9200
Practice Address - Street 1:7169 KALAMAZOO AVE SE STE 100
Practice Address - Street 2:
Practice Address - City:CALEDONIA
Practice Address - State:MI
Practice Address - Zip Code:49316
Practice Address - Country:US
Practice Address - Phone:616-266-9100
Practice Address - Fax:616-266-9200
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101012880207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI200044303OtherRAILROAD MEDICARE
MI874704973OtherDME WITH MEDICAID
MI200Z800130OtherBCBS
MI114316909Medicaid
MI0N82650Medicare PIN
MI0N82650004Medicare PIN
MI540Z810220OtherDME WITH BCBS