MEDICARE: DR. BARBRA A HORN M.D.

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	207RH0003X	Hematology & Oncology Physician	R3E10	MO
2	207RH0003X	Hematology & Oncology Physician	36086251	IL

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

General Provider Information

NPI Number	:	1295738961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BARBRA A HORN M.D.

Provider Business Mailing Address
First Line	:	4921 PARKVIEW PL
Second Line	:	STE 14B
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1032
Country	:	US
Telephone Number	:	314-454-5580
Fax Number	:	314-454-5583

Provider Business Practice Location Address
First Line	:	4921 PARKVIEW PL
Second Line	:	14B
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1032
Country	:	US
Telephone Number	:	314-454-5580
Fax Number	:	314-454-5583

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	11/23/2015

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