Provider Demographics
NPI:1134210149
Name:HORN, JEFFREY D (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:HORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 CHURCH ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2000
Mailing Address - Country:US
Mailing Address - Phone:615-329-9575
Mailing Address - Fax:615-329-9991
Practice Address - Street 1:2011 CHURCH ST
Practice Address - Street 2:SUITE 801
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2000
Practice Address - Country:US
Practice Address - Phone:615-329-9575
Practice Address - Fax:615-329-9991
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000029656207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4104671OtherBCBS ID
TN3815434Medicare ID - Type Unspecified
TNF61256Medicare UPIN