Provider Demographics
NPI:1952354524
Name:HORIZON CLINIC LLC
Entity Type:Organization
Organization Name:HORIZON CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:B
Authorized Official - Last Name:LEE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:270-824-3700
Mailing Address - Street 1:435 N KENTUCKY AVE
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-1768
Mailing Address - Country:US
Mailing Address - Phone:270-824-3700
Mailing Address - Fax:270-824-3701
Practice Address - Street 1:435 N KENTUCKY AVE
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-1768
Practice Address - Country:US
Practice Address - Phone:270-824-3700
Practice Address - Fax:270-824-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26014207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY=========OtherTAX ID # -HORIZON CLINIC
KY00009Medicare ID - Type UnspecifiedMEDICARE GROUP ID #