Provider Demographics
NPI:1033784988
Name:OWENS, ELIZA KAY (MD)
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:KAY
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZA
Other - Middle Name:KAY
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:551 E SOUTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-4236
Mailing Address - Country:US
Mailing Address - Phone:573-884-7733
Mailing Address - Fax:573-882-6228
Practice Address - Street 1:551 E SOUTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-4236
Practice Address - Country:US
Practice Address - Phone:573-884-7733
Practice Address - Fax:573-882-6228
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024010467207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine