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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265413017 | NPPES |
| Idaho | MEDICAID | 002781300 |
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