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NPI Code Detail

MEDICARE: DR. JOSEPH SAM OWEN JR. M.D.

MEDICARE: DR. JOSEPH SAM OWEN JR. M.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
1207R00000XInternal Medicine PhysicianT-1826MS
2207RC0000XCardiovascular Disease Physician19803MS
3207RC0001XClinical Cardiac Electrophysiology Physician19803MS

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 : 1578753943
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH SAM OWEN JR. M.D.
Provider Business Mailing Address
First Line : 970 LAKELAND DR STE 61
Second Line :
City : JACKSON
State : MS
Zip : 39216-4682
Country : US
Telephone Number : 601-982-7850
Fax Number : 601-366-8507
Provider Business Practice Location Address
First Line : 970 LAKELAND DR STE 61
Second Line :
City : JACKSON
State : MS
Zip : 39216-4682
Country : US
Telephone Number : 601-982-7850
Fax Number : 601-366-8507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2007
Last Update Date : 02/05/2024

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