Provider Demographics
NPI:1083625313
Name:HORNE, STEPHEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:K
Last Name:HORNE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 MCMILLAN RD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-5327
Mailing Address - Country:US
Mailing Address - Phone:318-329-4744
Mailing Address - Fax:318-329-4719
Practice Address - Street 1:503 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291
Practice Address - Country:US
Practice Address - Phone:318-329-4744
Practice Address - Fax:318-329-4719
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.06674R208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1349607Medicaid
LA1349607Medicaid
LA53837Medicare ID - Type Unspecified