Healthcare Provider Details

I. General information

NPI: 1801881602
Provider Name (Legal Business Name): JAMES M. HORNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 CHERRY ST SUITE 2300
TOLEDO OH
43608-2673
US

IV. Provider business mailing address

2200 JEFFERSON AVE 4TH FLOOR - CREDENTIALING
TOLEDO OH
43604-7101
US

V. Phone/Fax

Practice location:
  • Phone: 419-251-8025
  • Fax:
Mailing address:
  • Phone: 419-251-2673
  • Fax: 419-251-0916

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number35043478
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: