Provider Demographics
NPI:1407950934
Name:NOE, HORACE NORMAN (M D)
Entity Type:Individual
Prefix:DR
First Name:HORACE
Middle Name:NORMAN
Last Name:NOE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 ESTATE PL
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-0600
Mailing Address - Country:US
Mailing Address - Phone:901-287-4030
Mailing Address - Fax:901-287-4094
Practice Address - Street 1:770 ESTATE PL
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-0600
Practice Address - Country:US
Practice Address - Phone:901-287-4030
Practice Address - Fax:901-287-4094
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD00000066832086S0120X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Not Answered208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2005411OtherBLUE CROSS/BLUE SHIELD
2574838-004OtherCIGNA
40006683OtherUNITED HEALTHCARE
7343762OtherAETNA
TN1528Medicaid
TN000000122193Medicaid
TNB02730Medicaid
MS02733501Medicaid
TN000000122193Medicaid