Individual
JOHN A OWEN
Active
Individual
JOHN A OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
6196751-1205
UT
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
6196751-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
6196751-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107047838101
IHC
UT
01
—
61967511200001
BLUE CROSS
UT
05
—
870487570004
—
UT
01
—
870487570JHN
EMIA
UT
01
—
911238
DMBA
UT
Enumeration date
12/28/2005
Last updated
09/25/2018
Update your record
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