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General NPI Number Information
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NPI Number | 1891834594
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Entity Type | Individual
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Provider Name | CONNIE S HORN MD
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/27/2009
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Provider Practice Location Address
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Address Line | 807 W MAIN ST
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City | WILMINGTON
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State | OH
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Zip | 45177-2128
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Country | US
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Telephone | 937-382-1864
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Fax | 937-382-8917
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Provider Business Mailing Address
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Address Line | PO BOX 868 807 W MAIN ST
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City | WILMINGTON
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State | OH
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Zip | 45177-0868
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Country | US
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Telephone | 937-382-1864
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Fax | 937-382-8917
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 35051308
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License Number State | OH
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