Provider Demographics
NPI:1568991537
Name:HOMISON, LUKE (DO)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:
Last Name:HOMISON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHENANGO AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-1503
Mailing Address - Country:US
Mailing Address - Phone:724-342-3002
Mailing Address - Fax:724-342-1942
Practice Address - Street 1:1112 S MILL ST
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:PA
Practice Address - Zip Code:16101-4629
Practice Address - Country:US
Practice Address - Phone:724-658-4564
Practice Address - Fax:724-657-8563
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOS021488207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program