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NPI Code Detail

MEDICARE: DR. DOUGLAS NEAL HORNSBY M.D.

MEDICARE: DR. DOUGLAS NEAL HORNSBY M.D.
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
12085R0202XDiagnostic Radiology PhysicianME 83541FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1245292259
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS NEAL HORNSBY M.D.
Provider Business Mailing Address
First Line : 1353 BAY TER
Second Line :
City : NORTH BAY VILLAGE
State : FL
Zip : 33141-4002
Country : US
Telephone Number : 305-759-9293
Fax Number :
Provider Business Practice Location Address
First Line : 1353 BAY TER
Second Line :
City : NORTH BAY VILLAGE
State : FL
Zip : 33141-4002
Country : US
Telephone Number : 305-759-9293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 01/23/2008

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