Individual
CONNIE S HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
807 W MAIN ST, WILMINGTON, OH 45177-2128
(937) 382-1864
(937) 382-8917
Mailing address
PO BOX 868, 807 W MAIN ST, WILMINGTON, OH 45177-0868
(937) 382-1864
(937) 382-8917
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35051308
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000012224
ANTHEM
OH
05
—
0606562
—
OH
01
—
311127991
TAX ID
OH
Enumeration date
02/06/2007
Last updated
07/27/2009
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