Healthcare Provider Details

I. General information

NPI: 1811092976
Provider Name (Legal Business Name): MERIEM K BENSALEM-OWEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE STE B101
LEXINGTON KY
40536-0284
US

IV. Provider business mailing address

740 S LIMESTONE J 401
LEXINGTON KY
40536-0284
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5661
  • Fax: 859-323-6411
Mailing address:
  • Phone: 859-323-5661
  • Fax: 859-257-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License Number36699
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number36699
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number36699
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: