Owsley, Fredrick Mark

Owsley, Fredrick Mark is an sole proprietor health care provider with primary practice located at 980 W Ironwood Dr Ste 206, Coeur D Alene ID 83814-2668. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Owsley, Fredrick Mark can be contacted via phone (208) 664-0165.

Contact Information

Primary practice address
980 W Ironwood Dr Ste 206 Coeur D Alene ID 83814-2668
Phone: (208) 664-0165
Fax: (208) 664-5695
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X M6701 Idaho

Profile Details

NPI number 1265413017
LBN Legal business name Owsley, Fredrick Mark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2005
Last updated Sep 16th, 2015 - 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 1265413017 NPPES
Idaho MEDICAID 002781300

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