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NPI Code Detail

MEDICARE: DR. TIMOTHY H. HORNER M.D.

MEDICARE: DR. TIMOTHY H. HORNER 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
1174400000XSpecialist036089029IL
2207Q00000XFamily Medicine Physician036089029IL

General Provider Information

NPI Number : 1336246800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY H. HORNER M.D.
Provider Business Mailing Address
First Line : 101 W UNIVERSITY AVE
Second Line :
City : CHAMPAIGN
State : IL
Zip : 61820-3981
Country : US
Telephone Number : 217-442-8611
Fax Number :
Provider Business Practice Location Address
First Line : 3545 N VERMILION ST
Second Line :
City : DANVILLE
State : IL
Zip : 61832-1100
Country : US
Telephone Number : 217-442-8611
Fax Number : 217-366-6106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2006
Last Update Date : 11/06/2020

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