Provider Demographics
NPI:1477676427
Name:OWENS, CRYSTAL (MD)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2754 COMPASS DR STE 377
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-8723
Mailing Address - Country:US
Mailing Address - Phone:970-241-2212
Mailing Address - Fax:970-257-2401
Practice Address - Street 1:2754 COMPASS DR STE 377
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-8723
Practice Address - Country:US
Practice Address - Phone:970-241-2212
Practice Address - Fax:970-257-2401
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR0051929207Q00000X, 207QH0002X, 207QH0002X, 207RG0300X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000057906OtherGROUP PIN
UTUT03672OtherMEDICARE SUBMITTER ID NUM
UT005790605Medicare PIN
UTI22251Medicare UPIN