Individual
JOHN HORNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1965 S FREMONT AVE STE 100, SPRINGFIELD, MO 65804-2299
(417) 820-3800
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(855) 420-7900
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2013022994
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
MEDICARE
MO
05
—
PENDING
—
AR
05
—
PENDING
—
MO
05
—
PENDING
—
OK
Enumeration date
04/01/2011
Last updated
07/21/2022
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