Individual
DERRICK GLENN OWENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2121 PARK ST, JACKSONVILLE, FL 32204-3811
(904) 387-6200
Mailing address
2121 PARK ST, JACKSONVILLE, FL 32204-3811
(904) 387-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME140589
FL
Other
Enumeration date
03/22/2016
Last updated
06/04/2019
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