Provider Demographics
NPI:1558544841
Name:ROBERT LYNN HORNE MD LTD
Entity Type:Organization
Organization Name:ROBERT LYNN HORNE MD LTD
Other - Org Name:ROBERT LYNN HORNE, MN LTD
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD LTD
Authorized Official - Phone:702-822-1188
Mailing Address - Street 1:840 S RANCHO DR STE 4-244
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3837
Mailing Address - Country:US
Mailing Address - Phone:702-301-2555
Mailing Address - Fax:702-822-2020
Practice Address - Street 1:3017 W CHARLESTON BLVD STE 70
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1928
Practice Address - Country:US
Practice Address - Phone:702-822-1188
Practice Address - Fax:702-822-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-10
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5311261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002002776Medicaid
NV002002776Medicaid