Provider Demographics
NPI:1508962242
Name:OWENS, TIFFANY JANE (MD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:JANE
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-366-3687
Mailing Address - Fax:614-293-6176
Practice Address - Street 1:915 OLENTANGY RIVER RD FL 4
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212-3153
Practice Address - Country:US
Practice Address - Phone:614-366-3687
Practice Address - Fax:614-293-6176
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2024-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.091106207KA0200X
OH57-012148208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3027101Medicaid
OHH377950Medicare PIN