Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 156449 | OH |
Y | 208600000X | Surgeon | 156449 | OH |
NPI | 1003470428 |
---|---|
Provider Name | Stacy A Homan |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3039 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2019 |
Last Update Date | 01/05/2019 |