Provider Demographics
NPI:1144420118
Name:OWENS, AARON MICHAEL (DPM)
Entity Type:Individual
Prefix:
First Name:AARON
Middle Name:MICHAEL
Last Name:OWENS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3203 CARRINGTON LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-8645
Mailing Address - Country:US
Mailing Address - Phone:931-629-7176
Mailing Address - Fax:931-223-5459
Practice Address - Street 1:3203 CARRINGTON LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-8645
Practice Address - Country:US
Practice Address - Phone:931-629-7176
Practice Address - Fax:931-223-5459
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDPM 400213ES0131X
MS80116213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3350009Medicaid
TN4181079OtherBCBSTN
MS09253551Medicaid
MS512I480003Medicare PIN
TN3350009Medicare PIN