Individual
DR. DOUGLAS E HOMOKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 246-7766
Mailing address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 246-7766
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD031208
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000053389
ANTHEM
KY
01
—
003115442
BCBS OF TN
TN
05
—
005826497
—
VA
01
—
100028374
PHP TENNCARE
TN
05
—
1802969000
—
WV
01
—
208758
ANTHEM
VA
05
—
3700033
—
TN
05
—
64712292
—
KY
01
—
7586071
AETNA
TN
01
—
TN0113
UNITED HEALTHCARE RIVER V
TN
Enumeration date
09/12/2005
Last updated
05/27/2008
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