Healthcare Provider Details

I. General information

NPI: 1992743322
Provider Name (Legal Business Name): HARRY HORNE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 MCARTHUR AVE
CELINA TN
38551-4003
US

IV. Provider business mailing address

PO BOX 514
GAINESBORO TN
38562-0514
US

V. Phone/Fax

Practice location:
  • Phone: 931-243-5259
  • Fax: 931-243-5156
Mailing address:
  • Phone: 931-243-5259
  • Fax: 931-243-5156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number847
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO0000000847
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: