Provider Demographics
NPI:1295738961
Name:HORN, BARBRA A (MD)
Entity type:Individual
Prefix:DR
First Name:BARBRA
Middle Name:A
Last Name:HORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4921 PARKVIEW PL
Mailing Address - Street 2:STE 14B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1032
Mailing Address - Country:US
Mailing Address - Phone:314-454-5580
Mailing Address - Fax:314-454-5583
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:14B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-454-5580
Practice Address - Fax:314-454-5583
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3E10207RH0003X
IL36086251207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO202472338Medicaid
MO004010689Medicare PIN
MO202472338Medicaid