Provider Demographics
NPI:1497723001
Name:HORNE, DONNA GAYE (MD)
Entity Type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:GAYE
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:PO BOX 740968
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75374-0968
Mailing Address - Country:US
Mailing Address - Phone:480-481-4119
Mailing Address - Fax:480-675-4940
Practice Address - Street 1:9003 E SHEA BLVD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-323-3383
Practice Address - Fax:480-323-3358
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14085207RH0000X, 207ZC0500X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ162040Medicaid
E23911Medicare UPIN
AZ162040Medicaid
AZZ22WCGBV01Medicare PIN