MEDICARE: MRS. CATHERINE D HORNBECK P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 1909	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00035399	OTHER	AR	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5X115	OTHER	AR	BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	64-20055	OTHER	AR	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1093770109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CATHERINE D HORNBECK P.T.

Provider Business Mailing Address
First Line	:	2801 S OLIVE ST
Second Line	:	STE 9D
City	:	PINE BLUFF
State	:	AR
Zip	:	71603-5495
Country	:	US
Telephone Number	:	870-541-0003
Fax Number	:	870-541-0008

Provider Business Practice Location Address
First Line	:	2801 S OLIVE ST
Second Line	:	SUITE 9D
City	:	PINE BLUFF
State	:	AR
Zip	:	71603-5439
Country	:	US
Telephone Number	:	870-541-0003
Fax Number	:	870-541-0008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2006
Last Update Date	:	04/12/2016

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Directions to “ MRS. CATHERINE D HORNBECK P.T.” Practice Location

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