MR. FREDRICK MARK OWSLEY M.D. NPI 1265413017

NPI Information

NPI: 1265413017
Provider Name: MR. FREDRICK MARK OWSLEY, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

Address:
980 W IRONWOOD DR
STE 206
COEUR D ALENE, ID
ZIP 83814
Phone: (208) 664-0165
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MR. Fredrick Mark Owsley, M.D. is a specialist in Coeur D Alene, ID. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MR. Fredrick Mark Owsley, M.D. NPI is 1265413017. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

980 W IRONWOOD DR
STE 206
COEUR D ALENE, ID
ZIP 83814-668
Phone: (208) 664-0165
Fax: (208) 664-5695

The NPI 1265413017 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/9/2005 and was last updated on 9/16/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		M6701	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	002781300	MEDICAID	IDAHO
2	20006703	MEDICARE PIN	IDAHO
3	G05204	MEDICARE UPIN	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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