Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0102X | Surgical Critical Care | MD.32977 | AL |
N | 2086S0129X | Vascular Surgeon | 34035 | OK |
NPI | 1033478466 |
---|---|
Provider Name | Dr. Vernon D. Horst |
First Address | Tulsa, OK 74134-7168 |
Second Address | Tulsa, OK 74104-5635 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2012 |
Last Update Date | 25/03/2020 |