Provider Demographics
NPI:1861593964
Name:HORTON, JOHN H (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:HORTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412554
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64141-2554
Mailing Address - Country:US
Mailing Address - Phone:913-338-4515
Mailing Address - Fax:913-338-4606
Practice Address - Street 1:11301 ASH ST
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1643
Practice Address - Country:US
Practice Address - Phone:913-338-4515
Practice Address - Fax:913-338-4606
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24688207Q00000X
MOR4P35207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO18058041OtherBCBS OF KANSAS CITY PROVI
KSM113691OtherPROVIDER TRANSACTION ACCESS NUMBER (PTAN)
KS1861593964OtherNATIONAL PROVIDER IDENTIFIER (NPI)
KSM110000OtherGROUP OR EMPLOYER PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
KS1861593964OtherNATIONAL PROVIDER IDENTIFIER (NPI)