Healthcare Provider Details

I. General information

NPI: 1518060748
Provider Name (Legal Business Name): PHILIP J. HORN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PENN BLVD SUITE 100
PHILADELPHIA PA
19144-1476
US

IV. Provider business mailing address

101 E OLNEY AVE STE 400
PHILADELPHIA PA
19120-2470
US

V. Phone/Fax

Practice location:
  • Phone: 215-844-8570
  • Fax: 215-456-7052
Mailing address:
  • Phone: 215-456-1825
  • Fax: 215-456-5926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VC0200X
TaxonomyCritical Care Medicine (Obstetrics & Gynecology) Physician
License NumberMD033348E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: