Provider Demographics
NPI:1831182351
Name:HORNE, DANIEL W III (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:W
Last Name:HORNE
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3464 S. WILLOW ST
Mailing Address - Street 2:SUITE 159
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-4531
Mailing Address - Country:US
Mailing Address - Phone:303-755-2900
Mailing Address - Fax:303-745-7997
Practice Address - Street 1:3464 S. WILLOW ST
Practice Address - Street 2:SUITE 159
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-4531
Practice Address - Country:US
Practice Address - Phone:303-755-2900
Practice Address - Fax:303-745-7997
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2020-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO21909208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01219096Medicaid
CO0823860001Medicare NSC
CO01219096Medicaid
COC90928Medicare PIN