Individual
MR. JAMES KEITH HOMRIGHAUSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5120 CHARLESTOWN RD, STE 1, NEW ALBANY, IN 47150-9497
(812) 944-4000
(812) 944-4505
Mailing address
5120 CHARLESTOWN RD, STE 1, NEW ALBANY, IN 47150-9497
(812) 944-4000
(812) 944-4505
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
12010004
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
7213
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
12010004
IN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
7213
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005804
—
KY
05
—
1129756
—
KY
05
—
200161030
—
IN
05
—
60072139
—
KY
05
—
64072135
—
KY
Enumeration date
11/21/2005
Last updated
11/21/2014
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