Basic Information
| Provider Information | |||||||||
| NPI: | 1245260884 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOROWITZ | ||||||||
| FirstName: | IRA | ||||||||
| MiddleName: | ROBERT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., S.M. | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF GYNECOLOGY AND OBSTETRICS | ||||||||
| Address2: | 1365 CLIFTON ROAD, N.E. | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303220001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047783401 | ||||||||
| FaxNumber: | 4047782471 | ||||||||
| Practice Location | |||||||||
| Address1: | DEPARTMENT OF GYNECOLOGY AND OBSTETRICS | ||||||||
| Address2: | 1365 CLIFTON ROAD, N.E. | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303220001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047783401 | ||||||||
| FaxNumber: | 4047782471 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VX0201X | 036179 | GA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Gynecologic Oncology |
No ID Information.