Individual
DR. RUSSELL R HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
122 N PARK AVE, VALLEY CENTER, KS 67147-2553
(316) 755-1511
(316) 755-0991
Mailing address
122 N PARK AVE, VALLEY CENTER, KS 67147-2553
(316) 755-1511
(316) 755-0991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0520832
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000106575
BLUE CROSS BLUE SHIELD
KS
05
—
100229730C
—
KS
05
—
100229730E
—
KS
05
—
100416440A
—
KS
01
—
103177
BLUE CROSS INDIVIDUAL
KS
01
—
111178
BLUE CROSS BLUE SHIELD
KS
01
—
607740
FIRSTGUARD
KS
01
—
P00057331
RAIL ROAD MEDICARE
KS
Enumeration date
06/10/2005
Last updated
07/01/2008
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