Provider Demographics
NPI:1962549345
Name:OWENS, JAMES LEE (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:LEE
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:PO BOX 109
Mailing Address - Street 2:
Mailing Address - City:JARVISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27947-0109
Mailing Address - Country:US
Mailing Address - Phone:252-491-2885
Mailing Address - Fax:
Practice Address - Street 1:7107 CARATOKE HWY
Practice Address - Street 2:
Practice Address - City:JARVISBURG
Practice Address - State:NC
Practice Address - Zip Code:27947
Practice Address - Country:US
Practice Address - Phone:252-491-2885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC64654OtherBLUE CROSS
NC8964654Medicaid
NC8964654Medicaid
NC2314721Medicare PIN
NC2142434AMedicare ID - Type Unspecified