Individual
THEOPHILUS E OWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-5400
Mailing address
PO BOX 413033, SALT LAKE CITY, UT 84141-3033
(801) 213-3900
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
6543761-1205
UT
Other
Enumeration date
01/04/2006
Last updated
09/26/2012
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