Healthcare Provider Details

I. General information

NPI: 1225005358
Provider Name (Legal Business Name): BRANDON HORNE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E APPLE ST STE 2200
DAYTON OH
45409-2939
US

IV. Provider business mailing address

30 E APPLE ST STE 2200
DAYTON OH
45409-2939
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-2091
  • Fax:
Mailing address:
  • Phone: 937-208-2091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberL6067
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberL6067
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number35.092690
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: