Provider Demographics
NPI:1518060748
Name:HORN, PHILIP J (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:J
Last Name:HORN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:101 E OLNEY AVE
Mailing Address - Street 2:STE 400
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2470
Mailing Address - Country:US
Mailing Address - Phone:215-456-1825
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:1 PENN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-1476
Practice Address - Country:US
Practice Address - Phone:215-844-8570
Practice Address - Fax:215-456-7052
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2020-08-04
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Provider Licenses
StateLicense IDTaxonomies
PAMD033348E207VC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1238961Medicaid
PAA12706Medicare UPIN
PA625207Medicare ID - Type Unspecified