Eugene H Usow DO PA

Key facts

NPI

1235289778

Entity type

Organization (NPI type 2)

Primary specialty

Family Medicine Physician 207Q00000X

License

OS9612 (FL)

Legal business name

EUGENE H USOW DO PA

Practice address

709 Sebastian Blvd
Suite F
Sebastian, FL 32958-8704

Phone

(772) 228-9511

NPI assigned

Jan 10, 2007

Organization subpart

No

Authorized official

Name

Eugene Usow, D.O.

Title

President

Phone

(772) 228-9511

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 9, 2008.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1235289778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 SEBASTIAN BLVD",
            "address_2": "SUITE F",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329588704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 SEBASTIAN BLVD",
            "address_2": "SUITE F",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329588704",
            "telephone_number": "772-228-9511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE H USOW DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "USOW",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-228-9511",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS9612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2742519",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Sebastian, FL · Family Medicine Physician in Florida