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Individual

DR. SAMUEL HARVEY HORNER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
40 2ND ST NW, CLEVELAND, TN 37311-5009
(423) 476-5341
(423) 472-0321
Mailing address
40 2ND ST NW, CLEVELAND, TN 37311-5009
(423) 476-5341
(423) 472-0321

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
000963
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
113503
BLUE CROSS BLUE SHIELD
TN
05
113503
TN
01
602003553
CARITEN SR.
TN
Enumeration date
10/21/2005
Last updated
09/23/2015
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