STANFORD ALLEN OWEN


Address: 3300 15th St, Gulfport, MS 39501-3901
Phone: 2288649669

STANFORD ALLEN OWEN (NPI# 1972587418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972587418
Entity Type Individual
Full Name STANFORD ALLEN OWEN
Credential MD
Practice Address 3300 15th St
Gulfport
MS 39501-3901
Practice Telephone 2288649669
Practice Fax Number 2288649774
Mailing Telephone 2288649669
Mailing Fax Number 2288649774
Enumeration Date 2005-11-29
Last Update Date 2014-09-04
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207P00000X Emergency Medicine 08597 MS Allopathic & Osteopathic Physicians
Y 207R00000X Internal Medicine 08597 MS Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine 013830 LA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
MS 00017546 05
LA 1198455 05
MS RAILROAD MEDICARE 110121961 01
LA RAILROAD MEDICARE 110115663 01

Office Location

Street Address 3300 15TH ST
City GULFPORT
State MS
Zip Code 39501-3901

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477822526 Jeanne Schmidt Andry Dietitian, Registered 3300 15th St, Gulfport, MS 39501-3901 2011-12-19
1548421662 Center for Diabetes Management, Pllc Nurse Practitioner 3300 15th St, Gulfport, MS 39501-3901 2008-06-20
1558572438 Center for Health Management, The Internal Medicine 3300 15th St, Gulfport, MS 39501-3901 2007-05-24
1528004322 Internal Medicine Clinic of Picayune Internal Medicine 3300 15th St, Gulfport, MS 39501-3901 2006-06-21

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598301632 Daniel Edward Bloom Physician Assistant Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 2019-11-25
1730721374 Affinity Healthcare LLC Non-emergency Medical Transport (VAN) 1822 15th St, Suite 8, Gulfport, MS 39501 2019-10-15
1093361156 Gulf Coast Companion Care, LLC Home Health 1314 Pass Road, Ste B, Gulfport, MS 39501 2019-08-14
1609420991 Greg Meekin Ent Otolaryngology 1201 31st Avenue, Gulfport, MS 39501 2019-07-25
1225681216 Murphy Chiropractic Gulfport, LLC Clinic/Center 2700 25th Ave., Gulfport, MS 39501 2019-07-19
1477022838 Patriot Healthcare of Mississippi, LLC Family Medicine 1110 Broad Street, Suite 300, Gulfport, MS 39501 2018-11-15
1477003028 Mindful Matters Nurse Practitioner 1613 23rd Avenue, Gulfport, MS 39501 2016-10-06
1902294093 Tangular Barnes Nurse Practitioner Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 2014-12-25
1487065355 Huong Nguyen Pharmacist 2433 25th Avenue, Gulfport, MS 39501 2014-05-14
1770907412 Matthew Coleman Military Health Care Provider Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 2014-02-18
Find all providers in zip 39501

Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1457780975 George Robinson Sr. Internal Medicine 1 Hacienda Ln, Gulfport, MS 39507-4625 2013-11-05
1295965614 Virginia Arrington Blalack Internal Medicine 1340 Broad Ave Ste 310, Gulfport, MS 39501-2464 2009-07-20
1053577601 Liana Rodriguez Internal Medicine 2202 25th Ave Ste B, Gulfport, MS 39501-4520 2008-08-04
1447431598 Compton Healthcare Inc Internal Medicine 412 Security Sq, Gulfport, MS 39507-1952 2007-11-16
1093917908 Hansel J Janet Internal Medicine 2512 Palmer Dr, Gulfport, MS 39507-2245 2007-06-03
1730220815 Thomas M Poothullil Internal Medicine 2330 E Pass Rd, Suite 3, Gulfport, MS 39507-3817 2007-02-09
1619993367 Magdy Gorgi-mikhail Internal Medicine 1107 Cowan Rd Ste C&d, Gulfport, MS 39507-3442 2006-07-14
1649206210 Gail Farrar I Internal Medicine 1800 Beach Dr, Gulfport, MS 39507-1553 2006-06-24
1063452639 Thomas Blanks Internal Medicine 1110 Broad Ave, Suite 700, Gulfport, MS 39501-8907 2006-06-08
1356302574 Boyd P. Benefield Internal Medicine 15286 Community Rd, Gulfport, MS 39503-3509 2006-03-29
Find all providers in GULFPORT

Competitor

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City GULFPORT
Zip Code 39501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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