Healthcare Provider Details

I. General information

NPI: 1093654709
Provider Name (Legal Business Name): BRANDON HORN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7045 LIGHTHOUSE WAY
PERRYSBURG OH
43551-7000
US

IV. Provider business mailing address

2213 CHERRY ST
TOLEDO OH
43608-2603
US

V. Phone/Fax

Practice location:
  • Phone: 419-873-6836
  • Fax:
Mailing address:
  • Phone: 419-251-3232
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: