Individual
DR. JENISUS MARIE OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1101 S 28TH AVE STE C, HATTIESBURG, MS 39402-2610
(601) 261-1670
(601) 579-8381
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-5463
(601) 296-2802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25163
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08902261
—
MS
Enumeration date
07/15/2016
Last updated
04/30/2021
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