| Theresa M.hom Do Llc | |
|
1000 High St Suite I Worthington OH 43085-4044 | |
| (614) 840-0380 | |
| (614) 840-0385 |
| Full Name | Theresa M.hom Do Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1000 High St, Worthington, Ohio |
| Authorized Official Name and Position | Theresa M Hom (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6148400380 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa M.hom Do Llc 1000 High St Suite I Worthington OH 43085-4044 Ph: (614) 840-0380 | Theresa M.hom Do Llc 1000 High St Suite I Worthington OH 43085-4044 Ph: (614) 840-0380 |
| NPI Number | 1194892133 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 01/10/2012 |
| Medicare PECOS PAC ID | 1557380839 |
|---|---|
| Medicare Enrollment ID | O20051116000143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194892133 | NPI | - | NPPES |
| 1932123379 | Other | OH | 1932123379 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 34-004010 (Ohio) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | 34-004010 (Ohio) | Secondary |
| Provider Name | Theresa Maria Hom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932127933 PECOS PAC ID: 9537188818 Enrollment ID: I20100728000915 |
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