Provider Demographics
NPI:1679698914
Name:SCOTT A. HORNER MD UROLOGY LTD
Entity type:Organization
Organization Name:SCOTT A. HORNER MD UROLOGY LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-374-8818
Mailing Address - Street 1:640 WALNUT ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19601-3504
Mailing Address - Country:US
Mailing Address - Phone:610-374-8818
Mailing Address - Fax:610-374-3188
Practice Address - Street 1:640 WALNUT ST
Practice Address - Street 2:SUITE 305
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19601-3504
Practice Address - Country:US
Practice Address - Phone:610-374-8818
Practice Address - Fax:610-374-3188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-044922-L208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001499135005Medicaid
PA001499135005Medicaid
PAF89664Medicare UPIN