Individual
MARY JUNE OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
927 TRETTEL LN, CLOQUET, MN 55720-1345
(218) 879-1227
Mailing address
3245 HOSPITAL DR, JUNEAU, AK 99801-7809
(907) 463-4040
(907) 463-5868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44589
MN
207Q00000X
Family Medicine Physician
5223
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD5745
—
AK
Enumeration date
01/12/2007
Last updated
11/08/2019
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