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Individual

ROGER A OWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
29 RIDGEWOOD RD, THE PEDIATRIC NETWORK, SPRINGFIELD, VT 05156-3050
(802) 885-5716
Mailing address
PO BOX 2003, THE PEDIATRIC NETWORK, SPRINGFIELD, VT 05156-2003
(802) 885-5716

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042-0005683
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0004629
VT
05
30009000
NH
Enumeration date
07/27/2006
Last updated
07/08/2007
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