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NPI Code Detail

MEDICARE: KENNETH HORN MD

MEDICARE: KENNETH 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
1208000000XPediatrics PhysicianME22378FL

General Provider Information

NPI Number : 1922085190
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH HORN MD
Provider Business Mailing Address
First Line : 3945 SAN JOSE PARK DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4612
Country : US
Telephone Number : 904-731-3530
Fax Number : 904-737-1548
Provider Business Practice Location Address
First Line : 3945 SAN JOSE PARK DR
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32217-4612
Country : US
Telephone Number : 904-731-3530
Fax Number : 904-737-1548
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 05/24/2010

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Directions to “ KENNETH HORN MD” Practice Location

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