Healthcare Provider Details

I. General information

NPI: 1982665980
Provider Name (Legal Business Name): DOMINIC F. HOMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 11/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL CENTER DR SUITE #305
GADSDEN AL
35903-1134
US

IV. Provider business mailing address

100 MEDICAL CENTER DR SUITE #305
GADSDEN AL
35903-1134
US

V. Phone/Fax

Practice location:
  • Phone: 256-494-0990
  • Fax: 256-494-0948
Mailing address:
  • Phone: 256-494-0990
  • Fax: 256-494-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number00022313
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: