MEDICARE: DR. DALE S HORNE MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	35-087428	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023011707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALE S HORNE MD, PHD

Provider Business Mailing Address
First Line	:	3113 BELLEVUE AVE
Second Line	:	STE 4100
City	:	CINCINNATI
State	:	OH
Zip	:	45219-3286
Country	:	US
Telephone Number	:	513-221-1100
Fax Number	:	513-569-5297

Provider Business Practice Location Address
First Line	:	3113 BELLEVUE AVE STE 4100
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-3286
Country	:	US
Telephone Number	:	513-475-8990
Fax Number	:	513-475-8577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	06/15/2021

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