Individual
JON D HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 W ACADEMY STREET, GAINESVILLE, GA 30501
(770) 282-8820
Mailing address
107 CHURCH ST, JEFFERSON, GA 30549
(770) 630-4562
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
057821
GA
2085R0204X
Vascular & Interventional Radiology Physician
057821
GA
2085R0204X
Vascular & Interventional Radiology Physician
17433
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30BDNFF
MEDICARE ID
—
05
—
518091314
—
GA
05
—
518091314BN
—
GA
05
—
I74331
—
SC
Enumeration date
05/26/2006
Last updated
01/13/2021
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