Individual
WALLACE JENNINGS HORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 TILGHMAN DR, DUNN, NC 28334-5510
(910) 694-1000
(910) 891-6030
Mailing address
PO BOX 1706, 800 TILGHMAN DRIVE, DUNN, NC 28335-1706
(910) 694-1000
(910) 891-6030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101034381
VA
207Q00000X
Family Medicine Physician
0101034381
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5869862
—
VA
Enumeration date
11/11/2005
Last updated
11/08/2011
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