Provider Demographics
NPI:1538396239
Name:HORBAL, JONATHAN MICHAEL (DO PLC)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:MICHAEL
Last Name:HORBAL
Suffix:
Gender:M
Credentials:DO PLC
Other - Prefix:
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Mailing Address - Street 1:555 W WACKERLY ST
Mailing Address - Street 2:SUITE 2675
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4722
Mailing Address - Country:US
Mailing Address - Phone:989-631-1010
Mailing Address - Fax:989-839-8800
Practice Address - Street 1:555 W WACKERLY ST
Practice Address - Street 2:SUITE 2675
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4722
Practice Address - Country:US
Practice Address - Phone:989-631-1010
Practice Address - Fax:989-839-8800
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-19
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI390200000X
MI5101018381207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program