Provider Demographics
NPI:1508010505
Name:OWENS, JOSEPH RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RYAN
Last Name:OWENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 432
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41502-0432
Mailing Address - Country:US
Mailing Address - Phone:606-430-2225
Mailing Address - Fax:606-886-8176
Practice Address - Street 1:723 S LAKE DR
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-1340
Practice Address - Country:US
Practice Address - Phone:606-430-2225
Practice Address - Fax:606-886-8176
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY446442084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100171470Medicaid
KYK008481Medicare PIN