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General NPI Number Information
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NPI Number | 1861572349
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Entity Type | Individual
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Provider Name | RICKY LAWAYNE OWERS MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 1455 E BERT KOUNS LOOP #300
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City | SHREVEPORT
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State | LA
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Zip | 71105-5634
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Country | US
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Telephone | 318-798-4554
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Fax | 318-798-4581
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Provider Business Mailing Address
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Address Line | PO BOX 415000 LBX 410604
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City | NASHVILLE
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State | TN
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Zip | 37241-0604
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Country | US
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Telephone | 318-798-4554
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Fax | 318-798-4581
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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 | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | 201645
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License Number State | LA
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