Healthcare Provider Details

I. General information

NPI: 1770825937
Provider Name (Legal Business Name): DELIA MARIE HORN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS DELIA MARIE FRENCH

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 03/02/2021
Certification Date: 03/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GENERAL WING RD
RUTLAND VT
05701-4681
US

IV. Provider business mailing address

71 ALLEN POND SUITE 101
RUTLAND VT
05701-4570
US

V. Phone/Fax

Practice location:
  • Phone: 802-773-9131
  • Fax: 802-773-1551
Mailing address:
  • Phone: 802-772-4414
  • Fax: 802-772-7973

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number042.0013435
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number042-0013435
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: