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NPI Code Detail

MEDICARE: DR. JOSEPH ALEXANDER GOWEN O.D.

MEDICARE:  DR. JOSEPH ALEXANDER GOWEN  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist2486CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144246307
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH ALEXANDER GOWEN O.D.
Provider Business Mailing Address
First Line : 1130 LAKE PLAZA DR
Second Line : SUITE 230
City : COLORADO SPRINGS
State : CO
Zip : 80906-3594
Country : US
Telephone Number : 719-219-3819
Fax Number : 719-219-0411
Provider Business Practice Location Address
First Line : 1130 LAKE PLAZA DR
Second Line : SUITE 230
City : COLORADO SPRINGS
State : CO
Zip : 80906-3594
Country : US
Telephone Number : 719-219-3819
Fax Number : 719-219-0411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 09/19/2011

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Directions to “ DR. JOSEPH ALEXANDER GOWEN O.D.” Practice Location

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