Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 7960145-1205 | UT |
N | 207V00000X | Obstetrician & Gynecologist | MD61215011 | WA |
NPI | 1003072216 |
---|---|
Provider Name | Virginia Jean Homewood |
First Address | Salt Lake City, UT 84120-2000 |
Second Address | Salt Lake City, UT 84120-2000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2008 |
Last Update Date | 02/09/2021 |