| Doctor Name: | RUSSELL A HORN |
| NPI Number: | 1013907229 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | MA000101L |
| Business Practice Address: | 208 Lifeline Rd Suite 203 Stroudsburg, PA - 183606473 |
| Business Phone Number: | 5706648770 |
| Business Fax Number: | 5706648771 |
| Mailing Address: | 208 Lifeline Rd, Suite 203 STROUDSBURG |
| State: | PA |
| Postal Code: | 183606473 |
| Phone Number: | 5706648770 |
| Fax Number: | 5706648771 |
| NPI Enumeration Date: | 10/27/2005 |
| NPI Last Update Date: | 10/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | MA000101L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |