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Individual

JOHN A OWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1380 E MEDICAL CENTER DR, ST GEORGE, UT 84790-2123
(435) 688-4000
Mailing address
1308 E 900 S # C, ST GEORGE, UT 84790-8520
(354) 673-2301
(435) 673-2336

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
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