Provider Demographics
NPI:1447208822
Name:OWEN, ELIZABETH A (DO)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:OWEN
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:13943 N 91ST AVE
Mailing Address - Street 2:#C-101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3629
Mailing Address - Country:US
Mailing Address - Phone:623-760-9449
Mailing Address - Fax:623-974-9351
Practice Address - Street 1:14506 W GRANITE VALLEY DR
Practice Address - Street 2:124
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-6010
Practice Address - Country:US
Practice Address - Phone:623-584-2127
Practice Address - Fax:623-584-1257
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2013-10-04
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Provider Licenses
StateLicense IDTaxonomies
AZ2928207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1447208822OtherAHCCCS
AZ0852663OtherAETNA
AZAZ0227610OtherBLUE CROSS BLUE SHIELD
AZ188961600OtherDEPT OF LABOR WORK COMP
AZ070006426OtherRAILROAD MEDICARE
AZ1702257OtherUNITED HEALTHCARE
AZ347428Medicaid
AZ99S007000004OtherMEDISUN
AZ1Z1513OtherHEALTH NET
AZ070006426OtherRAILROAD MEDICARE
E90312Medicare UPIN