Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 35-087428 | OH |
NPI | 1023011707 |
---|---|
Provider Name | Dr. Dale S Horne |
First Address | Cincinnati, OH 45219-3286 |
Second Address | Cincinnati, OH 45219-3286 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2005 |
Last Update Date | 15/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0760401 | (05) | KY |
200147410 | (05) | IN |
2643438 | (05) | OH |
G49809 | (02) | IN |