Basic Information
Provider Information
NPI: 1518405836
EntityType: 2
ReplacementNPI:  
OrganizationName: M SAMIR HORANI MD INC PC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 1547
Address2:  
City: SEDALIA
State: MO
PostalCode: 653021547
CountryCode: US
TelephoneNumber: 6608265960
FaxNumber:  
Practice Location
Address1: 608 NW 9TH ST STE 6210
Address2:  
City: OKLAHOMA CITY
State: OK
PostalCode: 731021069
CountryCode: US
TelephoneNumber: 4052729641
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/07/2017
LastUpdateDate: 02/07/2017
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: HORANI
AuthorizedOfficialFirstName: M
AuthorizedOfficialMiddleName: SAMIR
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 4052729641
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: MD
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X  Y193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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