Provider Demographics
NPI:1780672816
Name:VANHORNE, CRAIG G (MD, PHD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:G
Last Name:VANHORNE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROSE ST
Mailing Address - Street 2:MS 106
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0001
Mailing Address - Country:US
Mailing Address - Phone:859-323-1334
Mailing Address - Fax:859-257-8902
Practice Address - Street 1:800 ROSE ST
Practice Address - Street 2:MS 106
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-1334
Practice Address - Fax:859-257-8902
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY44913207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1780672816OtherNPI
KY7100197470Medicaid
KY7100197470Medicaid