Healthcare Provider Details

I. General information

NPI: 1982667465
Provider Name (Legal Business Name): STEPHEN DAVID HORNOR M.A., A.T.,C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/07/2006
Last Update Date: 11/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIVERSITY OF CENTRAL ARKANSAS PRINCE CENTER - ROOM 133C
CONWAY AR
72035-0001
US

IV. Provider business mailing address

UNIVERSITY OF CENTRAL ARKANSAS PRINCE CENTER - ROOM 133C
CONWAY AR
72035-0001
US

V. Phone/Fax

Practice location:
  • Phone: 501-450-5106
  • Fax: 501-450-5087
Mailing address:
  • Phone: 501-450-5106
  • Fax: 501-450-5087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT 164
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: