Healthcare Provider Details

I. General information

NPI: 1033377064
Provider Name (Legal Business Name): DAVID LOUIS HORN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 06/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE MAILSTOP W-7729
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE MAILSTOP W-7729
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2105
  • Fax: 206-987-3878
Mailing address:
  • Phone: 206-987-2105
  • Fax: 206-987-3878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number01058253A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD60143669
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD60143669
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD436779
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD436779
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: