Individual
WILLIAM FRANCES OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3 LEAR JET LN STE 203, LATHAM, NY 12110-2322
(518) 250-5513
(844) 907-2966
Mailing address
3 LEAR JET LN, STE 203, LATHAM, NY 12110-2322
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
002360
NY
363AS0400X
Surgical Physician Assistant
Primary
002360
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000491283002
BLUE SHIELD
NY
01
—
060117000012
FIDELIS
NY
Enumeration date
07/17/2006
Last updated
06/06/2022
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