Provider Demographics
NPI:1710063086
Name:HORNING, JAMES ANTHONY (OD OPTOMETRIST)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANTHONY
Last Name:HORNING
Suffix:
Gender:M
Credentials:OD OPTOMETRIST
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Mailing Address - Street 1:4788 HODGES BLVD
Mailing Address - Street 2:STE 205
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224-7223
Mailing Address - Country:US
Mailing Address - Phone:904-992-9991
Mailing Address - Fax:904-246-0269
Practice Address - Street 1:4788 HODGES BLVD
Practice Address - Street 2:STE 205
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-7223
Practice Address - Country:US
Practice Address - Phone:904-992-9991
Practice Address - Fax:904-246-0269
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2022-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOPC001749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078411700Medicaid
T84222Medicare UPIN
19399Medicare ID - Type Unspecified