Paul Harvey Owen, PA-C
Individual provider Active NPI Surgical Physician Assistant · Ft. Gorden, GA
NPI 1659436129 · NPPES record last updated Feb 19, 2010
Key facts
- NPI
- 1659436129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgical Physician Assistant 363AS0400X
- Practice address
- 300 East Hospital Road
Eisenhower Army Medical Center
Ft. Gorden, GA 30905 - Phone
- (706) 787-9238
- NPI assigned
- Dec 26, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Yes |
Addresses
Primary practice location
300 East Hospital Road
Eisenhower Army Medical Center
Ft. Gorden, GA 30905
Mailing address
991 Louisville Rd
Harlem, GA 30814-4202
Phone (706) 556-3054
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.