Basic Information
| Provider Information | |||||||||
| NPI: | 1205210853 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LESTER | ||||||||
| FirstName: | HOMER | ||||||||
| MiddleName: | K | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | MSPA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1014 JOHNSTOWN RD | ||||||||
| Address2: | |||||||||
| City: | BECKLEY | ||||||||
| State: | WV | ||||||||
| PostalCode: | 258014940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3042524433 | ||||||||
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| Practice Location | |||||||||
| Address1: | 112 12TH ST | ||||||||
| Address2: | |||||||||
| City: | PRINCETON | ||||||||
| State: | WV | ||||||||
| PostalCode: | 247402312 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044877000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2015 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 1910 | WV | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AM0700X | 1910 | WV | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.