Healthcare Provider Details

I. General information

NPI: 1952764896
Provider Name (Legal Business Name): SUSAN ELIZABETH OWENS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S LIMESTONE
LEXINGTON KY
40536-1541
US

IV. Provider business mailing address

2120 L ST NW STE 450
WASHINGTON DC
20037-1541
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5901
  • Fax: 859-323-3040
Mailing address:
  • Phone: 202-741-2911
  • Fax: 202-741-2921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number57.027681
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD048253
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number56460
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: