Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 11168 | AL |
NPI | 1265463632 |
---|---|
Provider Name | John Owen |
First Address | Birmingham, AL 35255-5310 |
Second Address | Birmingham, AL 35233 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2006 |
Last Update Date | 08/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000016133 | (05) | AL |
000016133 | BLUE CROSS (01) | AL |
000093713 | (05) | AL |
000093713 | BLUE CROSS (01) | AL |
009936075 | (05) | AL |
009948185 | (05) | AL |
009948195 | (05) | AL |
009948205 | (05) | AL |
009948215 | (05) | AL |
009948225 | (05) | AL |
009948235 | (05) | AL |
009948245 | (05) | AL |
009972545 | (05) | AL |
009972565 | (05) | AL |
009972665 | (05) | AL |
051518000 | BLUE CROSS (01) | AL |
051521041 | BLUE CROSS (01) | AL |
051521042 | BLUE CROSS (01) | AL |
051521043 | BLUE CROSS (01) | AL |
051521045 | BLUE CROSS (01) | AL |