Basic Information
| Provider Information | |||||||||
| NPI: | 1538157102 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HORANZY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | RAYMOND | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | RR 2 BOX 396 | ||||||||
| Address2: | |||||||||
| City: | SULPHUR | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730869674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5806222279 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 107 S 3RD ST | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730302305 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5803692803 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 20039 | OK | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.