Basic Information
| Provider Information | |||||||||
| NPI: | 1023044757 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WILLIAM A HORN MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 552 | ||||||||
| Address2: | |||||||||
| City: | HATBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190400552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156725260 | ||||||||
| FaxNumber: | 2156725287 | ||||||||
| Practice Location | |||||||||
| Address1: | 331 N YORK RD | ||||||||
| Address2: | |||||||||
| City: | HATBORO | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190402033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2156725260 | ||||||||
| FaxNumber: | 2156725287 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | HORN | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | HEAD OF THE PRACTICE | ||||||||
| AuthorizedOfficialTelephone: | 2156725260 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | 0111080000 | 01 | PA | INDEPENDENCE BLUE CROSS | OTHER |