Provider Demographics
NPI:1457103723
Name:HOMAN, CARLTON ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLTON
Middle Name:ROSS
Last Name:HOMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 DOWNWOOD CIR NW STE 640A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1624
Mailing Address - Country:US
Mailing Address - Phone:707-778-7290
Mailing Address - Fax:404-686-5255
Practice Address - Street 1:3200 DOWNWOOD CIR NW STE 640A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1624
Practice Address - Country:US
Practice Address - Phone:707-778-7290
Practice Address - Fax:404-686-5255
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program