Provider Demographics
NPI:1588754071
Name:OWENS, MAMIE H (MD)
Entity type:Individual
Prefix:
First Name:MAMIE
Middle Name:H
Last Name:OWENS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-248-0200
Mailing Address - Fax:501-248-0100
Practice Address - Street 1:9600 BAPTIST HEALTH DR STE 340
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6322
Practice Address - Country:US
Practice Address - Phone:501-248-0200
Practice Address - Fax:501-248-0100
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-4106207VG0400X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154519001Medicaid
5M943Medicare PIN
I08595Medicare UPIN