Provider Demographics
NPI:1124202791
Name:HORNE, AMILDA KNOX (MD)
Entity Type:Individual
Prefix:
First Name:AMILDA
Middle Name:KNOX
Last Name:HORNE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 HIGHWAY 70 W
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-4510
Mailing Address - Country:US
Mailing Address - Phone:252-240-2349
Mailing Address - Fax:252-240-1840
Practice Address - Street 1:5420 HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4510
Practice Address - Country:US
Practice Address - Phone:252-240-2349
Practice Address - Fax:252-240-1840
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC391832084P0800X
LALAMD09617R2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry