MEDICARE: JEFFREY D HORN MD

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	207W00000X	Ophthalmology Physician	MD0000029656	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4104671	OTHER	TN	BCBS ID

General Provider Information

NPI Number	:	1134210149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY D HORN MD

Provider Business Mailing Address
First Line	:	2011 CHURCH ST
Second Line	:	SUITE 801
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2000
Country	:	US
Telephone Number	:	615-329-9575
Fax Number	:	615-329-9991

Provider Business Practice Location Address
First Line	:	2011 CHURCH ST
Second Line	:	SUITE 801
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2000
Country	:	US
Telephone Number	:	615-329-9575
Fax Number	:	615-329-9991

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/17/2007

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