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Individual

MR. JAMES KEITH HOMRIGHAUSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

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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