Provider Demographics
NPI:1659608784
Name:VAN HORN, SANDRA A (MD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:A
Last Name:VAN HORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:650 JOEL DR RM 2BH11C
Mailing Address - Street 2:
Mailing Address - City:FORT CAMPBELL
Mailing Address - State:KY
Mailing Address - Zip Code:42223-5318
Mailing Address - Country:US
Mailing Address - Phone:270-798-8117
Mailing Address - Fax:270-798-8544
Practice Address - Street 1:650 JOEL DR RM 2BH11C
Practice Address - Street 2:
Practice Address - City:FORT CAMPBELL
Practice Address - State:KY
Practice Address - Zip Code:42223-5318
Practice Address - Country:US
Practice Address - Phone:270-798-8117
Practice Address - Fax:270-798-8544
Is Sole Proprietor?:No
Enumeration Date:2009-11-10
Last Update Date:2025-05-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD15775208D00000X
HIMD-15775207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice