Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 35.091106 | OH |
N | 208000000X | Pediatrician | 57-012148 | OH |
NPI | 1508962242 |
---|---|
Provider Name | Dr. Tiffany Jane Owens |
First Address | Newark, OH 43055-9369 |
Second Address | Newark, OH 43055-9369 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2006 |
Last Update Date | 13/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3027101 | (05) | OH |