Provider Demographics
NPI:1710146907
Name:J P ROWEN SURGERY, PLC LLC
Entity Type:Organization
Organization Name:J P ROWEN SURGERY, PLC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:ROWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-954-8500
Mailing Address - Street 1:9501 LILE DR STE 888
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6233
Mailing Address - Country:US
Mailing Address - Phone:501-954-8500
Mailing Address - Fax:501-954-8502
Practice Address - Street 1:9501 LILE DR STE 888
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6233
Practice Address - Country:US
Practice Address - Phone:501-954-8500
Practice Address - Fax:501-954-8502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR143825001Medicaid
ARF66849Medicare UPIN