Healthcare Provider Details

I. General information

NPI: 1346353554
Provider Name (Legal Business Name): FRANCES L OWEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 WELLNESS WAY SUITE 7230
ST. SIMONS ISLAND GA
31522-2286
US

IV. Provider business mailing address

7000 WELLNESS WAY SUITE 7230
ST. SIMONS ISLAND GA
31522-2286
US

V. Phone/Fax

Practice location:
  • Phone: 912-634-2795
  • Fax: 912-638-5636
Mailing address:
  • Phone: 912-634-2795
  • Fax: 912-638-5636

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberGA040973
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: