Healthcare Provider Details

I. General information

NPI: 1558544841
Provider Name (Legal Business Name): ROBERT LYNN HORNE MD LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2007
Last Update Date: 03/20/2024
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3017 W CHARLESTON BLVD STE 70
LAS VEGAS NV
89102-1928
US

IV. Provider business mailing address

840 S RANCHO DR STE 4-244
LAS VEGAS NV
89106-3837
US

V. Phone/Fax

Practice location:
  • Phone: 702-822-1188
  • Fax: 702-822-2020
Mailing address:
  • Phone: 702-301-2555
  • Fax: 702-822-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number5311
License Number StateNV

VIII. Authorized Official

Name: DR. ROBERT LYNN HORNE
Title or Position: OWNER
Credential: MD LTD
Phone: 702-822-1188