Provider Demographics
NPI:1518251990
Name:HORN, EDWARD ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ROBERT
Last Name:HORN
Suffix:
Gender:M
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 35081 RPO WESTGATE
Mailing Address - Street 2:1309 CARLING AVE
Mailing Address - City:OTTAWA
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:K1Z1A2
Mailing Address - Country:CA
Mailing Address - Phone:613-722-6521
Mailing Address - Fax:
Practice Address - Street 1:1309 CARLING AVE
Practice Address - Street 2:ROYAL OTTAWA HOSPITAL
Practice Address - City:OTTAWA
Practice Address - State:ONTARIO
Practice Address - Zip Code:K1Z7K4
Practice Address - Country:CA
Practice Address - Phone:613-722-6521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152023208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice