Provider Demographics
NPI:1003810649
Name:MCCARRON, OWEN M (MD)
Entity Type:Individual
Prefix:
First Name:OWEN
Middle Name:M
Last Name:MCCARRON
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:855 A AVE NE
Mailing Address - Street 2:P O BOX 3080
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52406-3080
Mailing Address - Country:US
Mailing Address - Phone:319-221-8400
Mailing Address - Fax:319-221-8403
Practice Address - Street 1:701 10TH ST SE
Practice Address - Street 2:J EDWARD LUNDY PAVILION 4TH FLOOR
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-1251
Practice Address - Country:US
Practice Address - Phone:319-221-8400
Practice Address - Fax:319-221-8403
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2011-11-19
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Provider Licenses
StateLicense IDTaxonomies
IA31965207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAG49446Medicare UPIN