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General NPI Number Information
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NPI Number | 1801947320
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Entity Type | Individual
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Provider Name | MARY JUNE OWEN MD
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 11/08/2019
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Provider Practice Location Address
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Address Line | 927 TRETTEL LN
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City | CLOQUET
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State | MN
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Zip | 55720-1345
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Country | US
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Telephone | 218-879-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 3245 HOSPITAL DR
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City | JUNEAU
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State | AK
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Zip | 99801-7809
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Country | US
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Telephone | 907-463-4040
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Fax | 907-463-5868
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5223
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 44589
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License Number State | MN
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