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General NPI Number Information
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NPI Number | 1275498271
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Entity Type | Organization
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Legal Business Name | HOMETOWN CONNECT
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 1219 W JEFFERSON ST STE 206
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City | LOUISVILLE
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State | KY
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Zip | 40203-1790
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Country | US
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Telephone | 502-599-0264
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Fax |
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Provider Business Mailing Address
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Address Line | 1219 W JEFFERSON ST STE 206
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City | LOUISVILLE
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State | KY
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Zip | 40203-1790
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF CLINICAL OFFICER
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Name | DR. ANTONIO BOOKER
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Credential | PHARMD
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Telephone | 502-599-0264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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