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General NPI Number Information
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NPI Number | 1497791032
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Entity Type | Individual
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Provider Name | LORI LEIGH VAN HORN M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10411 COURTHOUSE RD SUITE A
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City | SPOTSYLVANIA
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State | VA
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Zip | 22553-1798
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Country | US
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Telephone | 540-710-6006
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Fax | 540-710-6001
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Provider Business Mailing Address
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Address Line | 9 LAWRENCE LN
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City | FREDERICKSBURG
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State | VA
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Zip | 22405-2968
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Country | US
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Telephone | 540-373-4794
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Fax | 540-710-6001
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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 | 0101050461
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License Number State | VA
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