Organization
JERRY ELLEN OWENSBY, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY ELLEN OWENSBY M.D. (M.D.)
(480) 610-8183
Entity
Organization
Contact information
Practice address
6242 E ARBOR AVE, SUITE 111, MESA, AZ 85206-1309
(480) 610-8183
(480) 610-8566
Mailing address
6242 E ARBOR AVE, SUITE 111, MESA, AZ 85206-1309
(480) 610-8183
(480) 610-8566
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
23843
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023413
CIGNA
AZ
01
—
AZ0838370
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
07/07/2006
Last updated
04/18/2008
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