Johnson, Homer Thomas
Johnson, Homer Thomas is an individual health care provider with primary practice located at 1475 Kisker Rd Suite 200, Saint Charles MO 63304-8781. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Sleep Medicine is his primary health care specialty. Johnson, Homer Thomas can be contacted via phone (636) 498-7880.Contact Information
Primary practice address
1475 Kisker Rd Suite 200
Saint Charles MO 63304-8781
Phone: (636) 498-7880
Fax: (636) 498-7889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME 97186 | Florida |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | NO. 2007001620 | Missouri |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207QS1201X | 2007001620 | Missouri |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 2080S0012X | 2007001620 | Missouri |
Profile Details
| NPI number | 1932223898 |
|---|---|
| LBN Legal business name | Johnson, Homer Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 18th, 2007 |
| Last updated | Mar 14th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932223898 | NPPES |
| Missouri | MEDICAID | 205475809 |
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