Provider Demographics
NPI:1568673580
Name:PHILIP F HORNE DPM PC
Entity Type:Organization
Organization Name:PHILIP F HORNE DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:F
Authorized Official - Last Name:HORNE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM,PC
Authorized Official - Phone:570-282-1107
Mailing Address - Street 1:34 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18407-1905
Mailing Address - Country:US
Mailing Address - Phone:570-282-1107
Mailing Address - Fax:570-282-1108
Practice Address - Street 1:34 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-1905
Practice Address - Country:US
Practice Address - Phone:570-282-1107
Practice Address - Fax:570-282-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC003378L213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5003940001Medicare NSC
PA071408Medicare ID - Type Unspecified