Provider Demographics
NPI:1770628927
Name:ROBERT J. HOMM, MD, PSC
Entity Type:Organization
Organization Name:ROBERT J. HOMM, MD, PSC
Other - Org Name:FERTILITY & ENDOCRINE ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:HOMM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-897-2144
Mailing Address - Street 1:4121 DUTCHMANS LN
Mailing Address - Street 2:SUITE 414
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4707
Mailing Address - Country:US
Mailing Address - Phone:502-897-2144
Mailing Address - Fax:502-897-1773
Practice Address - Street 1:4121 DUTCHMANS LN
Practice Address - Street 2:SUITE 414
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4707
Practice Address - Country:US
Practice Address - Phone:502-897-2144
Practice Address - Fax:502-897-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21579207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYC61283Medicare UPIN