Provider Demographics
NPI:1013117977
Name:HORN, GEOFFREY WILLIAM (DO)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:WILLIAM
Last Name:HORN
Suffix:
Gender:M
Credentials:DO
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 3222
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-0293
Mailing Address - Country:US
Mailing Address - Phone:707-261-7821
Mailing Address - Fax:707-256-3508
Practice Address - Street 1:10 WOODLAND RD
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-9554
Practice Address - Country:US
Practice Address - Phone:707-963-6430
Practice Address - Fax:707-256-3508
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK43692085R0202X
TN20632085R0202X
CA20A117012085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology