Provider Demographics
NPI:1528137650
Name:OWENS, ROBERT GREGORY (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:GREGORY
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7162 LIBERTY CENTRE DRIVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2748
Mailing Address - Country:US
Mailing Address - Phone:513-942-7640
Mailing Address - Fax:513-755-4736
Practice Address - Street 1:7162 LIBERTY CENTRE DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2748
Practice Address - Country:US
Practice Address - Phone:513-942-7640
Practice Address - Fax:513-755-4736
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350704310207VG0400X
TXJ6198O207VG0400X
LA021118207VG0400X
OH941083207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000185641OtherANTHEM
OH2441372OtherAETNA
OH07-02135OtherUNITED HEALTHCARE
OH0583097Medicaid
OH0583097Medicaid
OH160059162Medicare ID - Type UnspecifiedRAILROAD MEDICARE
OHF96592Medicare UPIN