Provider Demographics
NPI:1114133907
Name:OWENS, MICHAEL C (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:OWENS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 E CHEROKEE AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-5823
Mailing Address - Country:US
Mailing Address - Phone:580-234-7246
Mailing Address - Fax:580-233-2223
Practice Address - Street 1:427 E CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5823
Practice Address - Country:US
Practice Address - Phone:580-234-7246
Practice Address - Fax:580-233-2223
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4609207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine