Provider Demographics
NPI:1003850736
Name:OWEN, ROBERT DALE JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DALE
Last Name:OWEN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1401 HARRODSBURG RD
Mailing Address - Street 2:SUITE A540
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3751
Mailing Address - Country:US
Mailing Address - Phone:859-258-6760
Mailing Address - Fax:859-258-6512
Practice Address - Street 1:1401 HARRODSBURG RD
Practice Address - Street 2:SUITE A540
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504
Practice Address - Country:US
Practice Address - Phone:859-258-6760
Practice Address - Fax:859-258-6512
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2018-05-14
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Provider Licenses
StateLicense IDTaxonomies
KY36064207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY36064OtherLICENSE
KY36064OtherLICENSE