Individual
MR. OWEN JEFFERY CARR
Active
Individual
MR. OWEN JEFFERY CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008061
MEDICAL LICENSE
GA
01
—
PA 9109135
FLORIDA MEDICAL LICENSE
FL
Enumeration date
12/09/2015
Last updated
02/26/2019
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