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Individual

ROGER KIRK OWENS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4123 DUTCHMANS LN, SUITE 401, LOUISVILLE, KY 40207-4707
(502) 584-7525
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
43341
KY
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
43341
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000672943
NLS/ANTHEM
01
000052154Y
NLS/HUMANA
01
117506
NLS/SIHO
05
200995020
IN
01
50029766
NLS/PHP
05
7100126910
KY
01
9077569
NLS/AETNA
01
9662652
NLS/CIGNA
Enumeration date
02/01/2007
Last updated
01/20/2021
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