Provider Demographics
NPI:1801854443
Name:OWENS, KELLY A (MD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:OWENS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:600 PETER JEFFERSON PKWY
Mailing Address - Street 2:STE 290
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911
Mailing Address - Country:US
Mailing Address - Phone:434-977-4488
Mailing Address - Fax:434-977-6103
Practice Address - Street 1:600 PETER JEFFERSON PKWY
Practice Address - Street 2:STE 290
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911
Practice Address - Country:US
Practice Address - Phone:434-977-4488
Practice Address - Fax:434-977-6103
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0101230766207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H40710Medicare UPIN