Provider Demographics
NPI:1881282259
Name:OWEN, DONALD E JR
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:E
Last Name:OWEN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2686 HOMER RD NW
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:OH
Mailing Address - Zip Code:43080-9326
Mailing Address - Country:US
Mailing Address - Phone:614-563-7282
Mailing Address - Fax:
Practice Address - Street 1:2686 HOMER RD NW
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:OH
Practice Address - Zip Code:43080-9326
Practice Address - Country:US
Practice Address - Phone:614-563-7282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3081918Medicaid