Organization
H DOUGLAS HORNBECK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
H DOUGLAS HORNBECK MSSA (OWNER)
(330) 270-5454
Entity
Organization
Contact information
Practice address
4510 COLLINS BLVD, SUITE 4, ASHTABULA, OH 44004-6954
(330) 270-5454
(330) 270-0567
Mailing address
PO BOX 881, ASHTABULA, OH 44005-0881
(440) 992-9777
(440) 992-9683
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000199668
ANTHEM
OH
01
—
SP00131
MEDICARE PTAN
OH
Enumeration date
09/07/2007
Last updated
03/10/2008
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