Basic Information
| Provider Information | |||||||||
| NPI: | 1952764896 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OWENS | ||||||||
| FirstName: | SUSAN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2120 L ST NW STE 450 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200371541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027412911 | ||||||||
| FaxNumber: | 2027412921 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 S LIMESTONE | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 405361541 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8593235901 | ||||||||
| FaxNumber: | 8593233040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2016 | ||||||||
| LastUpdateDate: | 07/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 57.027681 | OH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | MD048253 | DC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | 56460 | KY | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.