Provider Demographics
NPI:1144326935
Name:STEVEN OWENS FAMILY PRACTICE, PLC
Entity type:Organization
Organization Name:STEVEN OWENS FAMILY PRACTICE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-676-3015
Mailing Address - Street 1:1100 S CEDAR ST
Mailing Address - Street 2:P.O. BOX 258
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-2009
Mailing Address - Country:US
Mailing Address - Phone:517-676-3015
Mailing Address - Fax:517-676-4250
Practice Address - Street 1:1100 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:MI
Practice Address - Zip Code:48854-2009
Practice Address - Country:US
Practice Address - Phone:517-676-3015
Practice Address - Fax:517-676-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015543207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIDA4621OtherRAILROAD MEDICARE
MIH92688Medicare UPIN
MIP2013004Medicare PIN
MIDA4621OtherRAILROAD MEDICARE