Provider Demographics
NPI:1730226259
Name:HORNICK, ANTHONY M (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:M
Last Name:HORNICK
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 1:2500 CANTERBURY DRIVE, SUITE 202
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601
Mailing Address - Country:US
Mailing Address - Phone:785-623-5945
Mailing Address - Fax:
Practice Address - Street 1:2500 CANTERBURY DRIVE, SUITE 202
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601
Practice Address - Country:US
Practice Address - Phone:785-623-5945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2018-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-20448174400000X
KS0420448208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No174400000XOther Service ProvidersSpecialist