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Individual

CLARENCE H OWEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
270 S MOON AVE, BRANDON, FL 33511-5711
(813) 571-9988
(813) 571-9922
Mailing address
270 S MOON AVE, BRANDON, FL 33511-5711
(813) 571-9988
(813) 571-9922

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
33925
NC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME157851
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1136E
BCBS
NC
01
1807389
UHC
NC
01
780001235
RR MCR
NC
01
80107
MEDCOST
NC
05
891136E
NC
Enumeration date
06/17/2005
Last updated
08/12/2022
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