Provider Demographics
NPI:1215928361
Name:HORN, ALLEN L (MD)
Entity type:Individual
Prefix:
First Name:ALLEN
Middle Name:L
Last Name:HORN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MN
Mailing Address - Zip Code:56352-1043
Mailing Address - Country:US
Mailing Address - Phone:320-256-4228
Mailing Address - Fax:320-256-7106
Practice Address - Street 1:525 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MN
Practice Address - Zip Code:56352-1043
Practice Address - Country:US
Practice Address - Phone:320-256-4228
Practice Address - Fax:320-256-7106
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN20473207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
600888OtherARAZ GROUP AMERICAS PPO
0120110OtherMEDICA HEALTH PLANS
889001OtherPREFERRED ONE
HP17771OtherHEALTH PARTNERS
47A48HOOtherBLUE CROSS BLUE SHIELD
0120109OtherMEDICA HEALTH PLANS
109967OtherUCARE
104094OtherMEDICA HEALTH PLANS
938029OtherFIRST HEALTH PLAN
0120108OtherMEDICA HEALTH PLANS
109967OtherUCARE