MEDICARE: HARRY HORNE DO

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	207P00000X	Emergency Medicine Physician	847	TN
2	207Q00000X	Family Medicine Physician	DO0000000847	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00231037	OTHER	TN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	890-26129	OTHER	AL	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	4072314	OTHER	TN	BCBS OF TN

General Provider Information

NPI Number	:	1992743322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRY HORNE DO

Provider Business Mailing Address
First Line	:	PO BOX 514
Second Line	:
City	:	GAINESBORO
State	:	TN
Zip	:	38562-0514
Country	:	US
Telephone Number	:	931-243-5259
Fax Number	:	931-243-5156

Provider Business Practice Location Address
First Line	:	151 MCARTHUR AVE
Second Line	:
City	:	CELINA
State	:	TN
Zip	:	38551-4003
Country	:	US
Telephone Number	:	931-243-5259
Fax Number	:	931-243-5156

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

Provider Enumeration Date	:	06/04/2006
Last Update Date	:	07/21/2022

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Directions to “ HARRY HORNE DO” Practice Location

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