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General NPI Number Information
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NPI Number | 1407858905
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Entity Type | Individual
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Provider Name | ROBERT G HORNBECK M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 2816 FOX MEADOW LN
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City | JONESBORO
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State | AR
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Zip | 72404
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Country | US
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Telephone | 870-336-1676
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Fax | 870-336-1679
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Provider Business Mailing Address
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Address Line | PO BOX 497
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City | AUGUSTA
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State | AR
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Zip | 72006-0497
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Country | US
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Telephone | 870-347-2534
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Fax | 870-347-3492
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E-1417
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License Number State | AR
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