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NPI Code Detail

MEDICARE: DR. LUKE HOMISON DO

MEDICARE: DR. LUKE HOMISON DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine PhysicianOS021488PA

General Provider Information

NPI Number : 1568991537
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUKE HOMISON DO
Provider Business Mailing Address
First Line : 100 SHENANGO AVE
Second Line :
City : SHARON
State : PA
Zip : 16146-1503
Country : US
Telephone Number : 724-342-3002
Fax Number : 724-342-1942
Provider Business Practice Location Address
First Line : 1112 S MILL ST
Second Line :
City : NEW CASTLE
State : PA
Zip : 16101-4629
Country : US
Telephone Number : 724-658-4564
Fax Number : 724-657-8563
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2017
Last Update Date : 08/06/2021

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