Dr Russell Horton, DO | |
21772 S Ellsworth Loop Rd, Queen Creek, AZ 85142-7709 | |
(480) 512-3700 | |
Not Available |
Full Name | Dr Russell Horton |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 21772 S Ellsworth Loop Rd, Queen Creek, Arizona |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1780996967 | NPI | - | NPPES |
R1814 | Other | AZ | TRAINING PERMIT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | R1814 (Arizona) | Primary |
Entity Name | Banner Primary Care Physicians Arizona Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1417238908 PECOS PAC ID: 6406020155 Enrollment ID: O20111115000898 |
Entity Name | Banner Physician Super Specialists Arizona Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841573870 PECOS PAC ID: 7911173794 Enrollment ID: O20111228000353 |
Entity Name | Banner Hospital Based Physicians Arizona Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275889891 PECOS PAC ID: 3274782487 Enrollment ID: O20121003000752 |
Entity Name | Banner Childrens Banner Health Clinic Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407191216 PECOS PAC ID: 2466697735 Enrollment ID: O20130315000131 |
Mailing Address | Practice Location Address |
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Dr Russell Horton, DO 21772 S Ellsworth Loop Rd, Queen Creek, AZ 85142-7709 Ph: (480) 512-3700 | Dr Russell Horton, DO 21772 S Ellsworth Loop Rd, Queen Creek, AZ 85142-7709 Ph: (480) 512-3700 |
Zaydee Montano Rivera, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 21772 S Ellsworth Loop Rd, Queen Creek, AZ 85142 Phone: 370-048-0512 | |
Dr. Milan Miloslav Hrkal Iii, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21321 E.ocotillo Rd., Ste.110, Queen Creek, AZ 85242 Phone: 480-677-4545 Fax: 480-677-4356 | |
Breeane Wazney, MD Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 21772 S Ellsworth Loop Rd, Queen Creek, AZ 85142 Phone: 480-512-3700 Fax: 480-512-3715 | |
Heather Kinnamon Dirkmaat, NMD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 20062 Ellsworth Rd, Building B, Queen Creek, AZ 85142 Phone: 303-210-0662 | |
Emilia Elizabeth Gomez Vieytez, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 22707 S. Ellsworth Rd H 101, Queen Creek, AZ 85143 Phone: 480-792-9200 Fax: 480-792-9206 | |
Brian Douglas Dewitt, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 21321 E Ocotillo Rd Ste 110, Queen Creek, AZ 85142 Phone: 480-677-4545 |