Provider Demographics
NPI:1174139604
Name:HORNER, DARION MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:DARION
Middle Name:MICHAEL
Last Name:HORNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 SAND PIKE BLVD
Mailing Address - Street 2:
Mailing Address - City:PIGEON FORGE
Mailing Address - State:TN
Mailing Address - Zip Code:37863-6205
Mailing Address - Country:US
Mailing Address - Phone:865-428-0959
Mailing Address - Fax:
Practice Address - Street 1:2541 SAND PIKE BLVD
Practice Address - Street 2:
Practice Address - City:PIGEON FORGE
Practice Address - State:TN
Practice Address - Zip Code:37863-6205
Practice Address - Country:US
Practice Address - Phone:865-428-0959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3647152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist