Provider Demographics
NPI:1013994748
Name:HOMA, JOHN J (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:HOMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:110 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3127
Mailing Address - Country:US
Mailing Address - Phone:508-771-9550
Mailing Address - Fax:508-790-9304
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3127
Practice Address - Country:US
Practice Address - Phone:508-771-9550
Practice Address - Fax:508-790-9304
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA224176208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ29178OtherBLUE CROSS BLUE SHIELD
MAAA42137OtherHARVARD PILGRIM HEALTH
MA000000031582OtherBMC HEALTHNET
MA470474OtherTUFTS HEALTH PLAN
MA470474OtherTUFTS HEALTH PLAN
MAAA42137OtherHARVARD PILGRIM HEALTH