Provider Demographics
NPI:1225583032
Name:OWENS, RICK L JR
Entity Type:Individual
Prefix:
First Name:RICK
Middle Name:L
Last Name:OWENS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 F ST SW
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-4705
Mailing Address - Country:US
Mailing Address - Phone:405-326-7614
Mailing Address - Fax:
Practice Address - Street 1:115 F ST SW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-4705
Practice Address - Country:US
Practice Address - Phone:405-326-7614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit