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Individual

DR. DERON L HORMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1134 N MAIN ST STE 1100, BELLEFONTAINE, OH 43311
(937) 651-6820
(937) 651-6822
Mailing address
1134 N MAIN ST STE 1100, BELLEFONTAINE, OH 43311-2379
(937) 651-6820
(937) 651-6822

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35067435H
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2055430
OH
01
P00386660
RR MEDICARE
OH
Enumeration date
11/05/2005
Last updated
05/24/2018
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