Provider Demographics
NPI:1306894365
Name:HOROWITZ, CARL DAVID (DPM)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:DAVID
Last Name:HOROWITZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 S ARLINGTON ST UNIT 38
Mailing Address - Street 2:PO BOX 7695
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3771
Mailing Address - Country:US
Mailing Address - Phone:330-724-5471
Mailing Address - Fax:330-786-0108
Practice Address - Street 1:1400 S ARLINGTON ST UNIT 38
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3771
Practice Address - Country:US
Practice Address - Phone:330-724-5471
Practice Address - Fax:330-786-0108
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-003460213E00000X
KY00316213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2966358Medicaid
OH4273522Medicare PIN
KYV09984Medicare UPIN
OH2966358Medicaid
KY00079001Medicare PIN