Healthcare Provider Details

I. General information

NPI: 1447231527
Provider Name (Legal Business Name): BRIAN PAUL HORST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4116 LARAMIE ST
CHEYENNE WY
82001-1969
US

IV. Provider business mailing address

4116 LARAMIE ST
CHEYENNE WY
82001-1969
US

V. Phone/Fax

Practice location:
  • Phone: 307-635-7961
  • Fax: 307-778-5812
Mailing address:
  • Phone: 307-635-7961
  • Fax: 307-778-5812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number6424A
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number6424A
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: