Provider Demographics
NPI:1992744718
Name:OWEN, JOHN SKELTON JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SKELTON
Last Name:OWEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 830230
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35283-0230
Mailing Address - Country:US
Mailing Address - Phone:205-250-6000
Mailing Address - Fax:205-250-6848
Practice Address - Street 1:1 INDEPENDENCE PLZ
Practice Address - Street 2:STE. 700
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2629
Practice Address - Country:US
Practice Address - Phone:205-250-6042
Practice Address - Fax:205-250-8944
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL10337207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000014660Medicaid
000014660Medicare PIN
AL000014660Medicaid