Provider Demographics
NPI:1477560084
Name:OWENS, DENNIS W (MD)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:W
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHESTNUT ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01199-1619
Mailing Address - Country:US
Mailing Address - Phone:413-794-5700
Mailing Address - Fax:
Practice Address - Street 1:325B KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2370
Practice Address - Country:US
Practice Address - Phone:413-387-4101
Practice Address - Fax:413-387-4119
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2015-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA44886207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00209028OtherRAILROAD MEDICARE CARRIER
B74880Medicare UPIN
MAJ06515Medicare ID - Type Unspecified
NY060MA448860Medicaid
MA44886OtherCDPHP