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Individual
MR. RANDALL LEE OWEN
Active
Individual
MR. RANDALL LEE OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110004314
VA
363A00000X
Physician Assistant
23.003095
CT
363A00000X
Physician Assistant
MA056252
PA
363AM0700X
Medical Physician Assistant
23.003095
CT
363AS0400X
Surgical Physician Assistant
Primary
23.003095
CT
Other
Enumeration date
07/25/2013
Last updated
06/29/2021
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