Healthcare Provider Details

I. General information

NPI: 1669470373
Provider Name (Legal Business Name): MICHELLE MCDANIEL OWENS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LENA MICHELLE MCDANIEL M.D.

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 ODD FELLOWS RD STE B
CROWLEY LA
70526-2208
US

IV. Provider business mailing address

423 E 5TH ST
CROWLEY LA
70526-4527
US

V. Phone/Fax

Practice location:
  • Phone: 337-785-2006
  • Fax: 337-785-2016
Mailing address:
  • Phone: 337-785-9922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number12971R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: