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General NPI Number Information
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NPI Number | 1780604587
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Entity Type | Organization
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Legal Business Name | DONALD L HORNEY, MD, PC
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1332 S COUNTRY CLUB DR
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City | GALLUP
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State | NM
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Zip | 87301-5665
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Country | US
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Telephone | 505-863-2134
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Fax | 505-863-8900
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Provider Business Mailing Address
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Address Line | PO BOX 218
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City | GALLUP
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State | NM
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Zip | 87305-0218
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Country | US
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Telephone | 505-870-0640
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONALD L HORNEY
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Credential | PH.D., M.D.
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Telephone | 505-870-0640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 91-222
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License Number State | NM
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