Provider Demographics
NPI:1285746289
Name:HORWITZ, JEFFREY ALANSON (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALANSON
Last Name:HORWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W 1ST ST
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45402-3033
Mailing Address - Country:US
Mailing Address - Phone:937-228-5015
Mailing Address - Fax:937-228-5971
Practice Address - Street 1:301 W 1ST ST
Practice Address - Street 2:SUITE 3A
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45402-3033
Practice Address - Country:US
Practice Address - Phone:937-228-5015
Practice Address - Fax:937-228-5971
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.030036207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH50184OtherCIGNA
OH0218044Medicaid
OHD30036OtherHUMANA
OH0820105OtherUNITED HEALTHCARE
OH4256470OtherAETNA PIN
OH000000006864OtherANTHEM BC & BS PIN
OH1147218OtherUMWA
OHD30036OtherHUMANA
OH0820105OtherUNITED HEALTHCARE