Provider Demographics
NPI:1700900040
Name:JEFFREY D HORN MD PLLC
Entity Type:Organization
Organization Name:JEFFREY D HORN MD PLLC
Other - Org Name:VISION FOR LIFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-329-9575
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN29656207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3730182Medicare ID - Type Unspecified