Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | DR.0066623 | CO |
N | 208D00000X | General Practice Physician | 0102204110 | VA |
NPI | 1003159146 |
---|---|
Provider Name | Dr. Gaelen Royce Horne |
First Address | Loveland, CO 80538-9071 |
Second Address | Colorado Springs, CO 80909-5533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 22/06/2021 |