Individual
DAVID ALAN HORNBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
621 MEMORIAL DR STE 100, SOUTH BEND, IN 46601-1063
(574) 647-1100
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01037607
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001760
—
IN
Enumeration date
09/14/2005
Last updated
07/01/2021
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