Provider Demographics
NPI:1992196752
Name:NEW HORIZONS MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NEW HORIZONS MEDICAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-529-2834
Mailing Address - Street 1:305 W JACKSON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-1474
Mailing Address - Country:US
Mailing Address - Phone:618-529-2834
Mailing Address - Fax:618-457-0440
Practice Address - Street 1:305 W JACKSON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-1474
Practice Address - Country:US
Practice Address - Phone:618-529-2834
Practice Address - Fax:618-457-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty