Healthcare Provider Details

I. General information

NPI: 1619913514
Provider Name (Legal Business Name): LEE STEVEN HORNSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 WOODLAKE TRL SUITE C
MOUNT VERNON OH
43050-9573
US

IV. Provider business mailing address

10 WOODLAKE TRL SUITE C
MOUNT VERNON OH
43050-9573
US

V. Phone/Fax

Practice location:
  • Phone: 740-392-7337
  • Fax: 740-392-7333
Mailing address:
  • Phone: 740-392-7337
  • Fax: 740-392-7333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.050343
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: