Provider Demographics
NPI:1538169065
Name:OWENS, ROBERT CARL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CARL
Last Name:OWENS
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 1:207 HARDINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-7462
Mailing Address - Country:US
Mailing Address - Phone:919-751-9481
Mailing Address - Fax:
Practice Address - Street 1:2401 WAYNE MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-1727
Practice Address - Country:US
Practice Address - Phone:919-736-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26037207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8964675Medicaid
NC64675OtherBCBSNC
NC64675OtherBCBSNC
NC8964675Medicaid