Provider Demographics
NPI:1497069298
Name:OWENS, DEYZI E (MD)
Entity Type:Individual
Prefix:DR
First Name:DEYZI
Middle Name:E
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEYZI
Other - Middle Name:E
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:13126 TECUMSEH RD E, STE 2
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:ON
Mailing Address - Zip Code:N8N3T6
Mailing Address - Country:CA
Mailing Address - Phone:519-956-8867
Mailing Address - Fax:519-956-8317
Practice Address - Street 1:13126 TECUMSEH RD E, STE 2
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:ON
Practice Address - Zip Code:N8N3T6
Practice Address - Country:CA
Practice Address - Phone:519-956-8867
Practice Address - Fax:519-956-8317
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine