Provider Demographics
NPI:1114011202
Name:HORNSBY, THOMAS M II (DPT,ECS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:M
Last Name:HORNSBY
Suffix:II
Gender:M
Credentials:DPT,ECS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1148 RABBIT CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-6983
Mailing Address - Country:US
Mailing Address - Phone:828-369-3871
Mailing Address - Fax:
Practice Address - Street 1:235 JIM BERRY RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-8660
Practice Address - Country:US
Practice Address - Phone:828-369-7878
Practice Address - Fax:828-369-8760
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC3507225100000X
NC57102251E1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2502748OtherMEDICARE GROUP #
NCB8365OtherMEDCOST #
NC7211277Medicaid
NC0796HOtherBLUE CROSS BLUE SHIELD #
NC720797PMedicaid
NCCF8693OtherGROUP # FOR RR MEDICARE
NC0796HOtherBLUE CROSS BLUE SHIELD #