Provider Demographics
NPI:1538335583
Name:OWENS, LAURA LEE (MD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LEE
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:PO BOX 191
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:DE
Mailing Address - Zip Code:19732-0191
Mailing Address - Country:US
Mailing Address - Phone:904-697-4096
Mailing Address - Fax:302-651-4945
Practice Address - Street 1:1600 ROCKLAND RD
Practice Address - Street 2:DEPARTMENT OF PEDIATRIC REHABILITATION MEDICINE
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3607
Practice Address - Country:US
Practice Address - Phone:302-651-4200
Practice Address - Fax:302-651-5612
Is Sole Proprietor?:No
Enumeration Date:2008-04-30
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC100107042081P0010X
PAMD447139208D00000X, 2081P0010X, 2081P0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPediatric Rehabilitation Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0399281Medicaid
PA102876229Medicaid
MD0209511 00Medicaid