Provider Demographics
NPI:1881655249
Name:OWENS, JAMES B (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:B
Last Name:OWENS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 HIGHMARKET ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-2910
Mailing Address - Country:US
Mailing Address - Phone:843-546-3020
Mailing Address - Fax:843-527-1816
Practice Address - Street 1:2504 HIGHMARKET ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:SC
Practice Address - Zip Code:29440-2910
Practice Address - Country:US
Practice Address - Phone:843-546-3020
Practice Address - Fax:843-527-1816
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT23959Medicare UPIN
SCT239596931Medicare ID - Type Unspecified