Basic Information
| Provider Information | |||||||||
| NPI: | 1427154822 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROBERT R. HORANZY M.D. LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | RR 2 BOX 396 | ||||||||
| Address2: | |||||||||
| City: | SULPHUR | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730869674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803692803 | ||||||||
| FaxNumber: | 5803693497 | ||||||||
| Practice Location | |||||||||
| Address1: | 107 S 3RD ST | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730302305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803692803 | ||||||||
| FaxNumber: | 5803693497 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HORANZY | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | RAYMOND | ||||||||
| AuthorizedOfficialTitleorPosition: | PLLC | ||||||||
| AuthorizedOfficialTelephone: | 5803692803 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20039 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 168463590-001 | 01 | OK | BLUECROSS | OTHER |