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
Fax: (636) 498-7889
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932223898 NPPES
Missouri MEDICAID 205475809

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