Provider Demographics
NPI:1841809159
Name:HORD, CAMERON R
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:R
Last Name:HORD
Suffix:
Gender:M
Credentials:
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 92
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164-0092
Mailing Address - Country:US
Mailing Address - Phone:304-531-7840
Mailing Address - Fax:
Practice Address - Street 1:313 GOOD ST
Practice Address - Street 2:
Practice Address - City:RAVENSWOOD
Practice Address - State:WV
Practice Address - Zip Code:26164-4608
Practice Address - Country:US
Practice Address - Phone:304-531-7840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant