Individual
MAX EDWARD OWEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2405 WEST MAIN, HENRYETTA, OK 74437-3893
(918) 650-1180
(918) 650-1294
Mailing address
2405 W MAIN ST, HENRYETTA, OK 74437-3893
(918) 650-1180
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1540
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1540
PHYSICIAN ASSISTANTS
OK
Enumeration date
08/01/2006
Last updated
03/19/2013
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