Provider Demographics
NPI:1194805150
Name:JAMES K HORLACHER MD INC
Entity type:Organization
Organization Name:JAMES K HORLACHER MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:HORLACHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-208-4110
Mailing Address - Street 1:1 WYOMING ST
Mailing Address - Street 2:SUITE 4140
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:937-208-4110
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:SUITE 4140
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-4110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033673207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0169339Medicaid
4013797OtherAETNA HEALTH PLANS
000000012161OtherANTHEM BCBS
F97671Medicare UPIN
9922672Medicare ID - Type Unspecified