Horn, Russell Hamilton
Horn, Russell Hamilton is an individual health care provider with primary practice located at 880 Golf View Dr Ste 101 , Medford OR 97504-8496. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Horn, Russell Hamilton can be contacted via phone (541) 779-3797.Contact Information
Primary practice address
880 Golf View Dr Ste 101
Medford OR 97504-8496
Phone: (541) 779-3797
Fax: (541) 842-2194
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 13570T | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2513ATI | Oregon |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2513T | Oregon |
Profile Details
| NPI number | 1942211792 |
|---|---|
| LBN Legal business name | Horn, Russell Hamilton |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 10th, 2006 |
| Last updated | May 29th, 2024 - about 7 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942211792 | NPPES |
| California | Other | DO053A | PTAN |
| California | MEDICAID | 082938 | PTAN |
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