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General NPI Number Information
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NPI Number | 1770103186
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Entity Type | Individual
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Provider Name | JOSEPH BRET OWENS MD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2020
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 11258 FORD AVE STE 13
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City | RICHMOND HILL
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State | GA
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Zip | 31324-8880
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Country | US
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Telephone | 407-456-2031
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Fax | 912-514-0045
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Provider Business Mailing Address
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Address Line | 305 LOGGING HILL DR
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City | RICHMOND HILL
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State | GA
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Zip | 31324-6841
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Country | US
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Telephone | 407-456-2031
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 98691
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 98691
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License Number State | GA
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