Owen, Stanford Allen

Owen, Stanford Allen is an sole proprietor health care provider with primary practice located at 3300 15Th St , Gulfport MS 39501-3901. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Owen, Stanford Allen can be contacted via phone (228) 864-9669.

Contact Information

Primary practice address
3300 15Th St Gulfport MS 39501-3901
Phone: (228) 864-9669
Fax: (228) 864-9774
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 013830 Louisiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 08597 Mississippi
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 08597 Mississippi

Profile Details

NPI number 1972587418
LBN Legal business name Owen, Stanford Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 29th, 2005
Last updated Sep 4th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972587418 NPPES
Mississippi MEDICAID 00017546
Mississippi Other 110115663
Mississippi MEDICAID 1198455
Mississippi Other 110121961

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