Provider Demographics
NPI:1154855583
Name:OWENS, TIMOTHY BROOKS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:BROOKS
Last Name:OWENS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:3925 RIVERBEND RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-6823
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1240 COLONIAL COMMONS CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:SC
Practice Address - Zip Code:29720-2200
Practice Address - Country:US
Practice Address - Phone:803-285-4333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-12
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116031349207W00000X
SC51112207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology