Individual
DR. RUSSELL HAMILTON HORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
880 GOLF VIEW DR STE 101, MEDFORD, OR 97504-8496
(541) 779-3797
(541) 842-2194
Mailing address
880 GOLF VIEW DR STE 101, MEDFORD, OR 97504-8496
(541) 779-3797
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
13570T
CA
152W00000X
Optometrist
2513ATI
OR
152W00000X
Optometrist
Primary
2513T
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
082938
—
OR
01
—
DO053A
PTAN
CA
Enumeration date
08/10/2006
Last updated
05/29/2024
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