Provider Demographics
NPI:1144804675
Name:HOMAN, BRANDON M (OD)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:M
Last Name:HOMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 STATE ST
Mailing Address - Street 2:
Mailing Address - City:BADEN
Mailing Address - State:PA
Mailing Address - Zip Code:15005-1737
Mailing Address - Country:US
Mailing Address - Phone:724-869-1870
Mailing Address - Fax:724-869-8113
Practice Address - Street 1:400 STATE ST
Practice Address - Street 2:
Practice Address - City:BADEN
Practice Address - State:PA
Practice Address - Zip Code:15005-1737
Practice Address - Country:US
Practice Address - Phone:724-869-1870
Practice Address - Fax:724-869-8113
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003770152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist