THEOPHILUS E OWAN


Address: 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103
Phone: 8016625400

THEOPHILUS E OWAN (NPI# 1982682647) 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) 1982682647
Entity Type Individual
Full Name THEOPHILUS E OWAN
Credential M.D.
Practice Address 100 Mario Capecchi Dr
Salt Lake City
UT 84113-1103
Mailing Address Po Box 413033
Salt Lake City
UT 84141-3033
Practice Telephone 8016625400
Mailing Telephone 8012133900
Enumeration Date 2006-01-04
Last Update Date 2012-09-26
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RI0011X Internal Medicine
Specialization: Interventional Cardiology
6543761-1205 UT Allopathic & Osteopathic Physicians

Office Location

Street Address 100 MARIO CAPECCHI DR
City SALT LAKE CITY
State UT
Zip Code 84113-1103

Providers in the same location

NPI Name Taxonomy Address Enumeration
1033111810 Andrew Gerald Smith Legal Medicine 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2005-08-11
1235535485 Ihc Health Services Inc Clinic/Center 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-11-17
1508262833 Aimee Brierley Occupational Therapist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-11-13
1801290986 Jeffery Zobell Pharmacist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-10-17
1336542778 Bevan Jensen Pharmacist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-09-30
1699183152 Kristina Rogers Dentist 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-07-29
1548677297 Stephanie Eva Wisniewski Speech-Language Pathologist 100 Mario Capecchi Dr, Primary Children's Rehab, Salt Lake City, UT 84113-1103 2014-07-15
1184044877 Adam Wesley Dell Pediatrics 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-04-21
1225456718 Bhanu Muniyappa Pediatrics 100 Mario Capecchi Dr, Pediatrics Residency Program, Salt Lake City, UT 84113-1103 2014-04-01
1265850952 Kristina Gulliver Pediatrics 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2014-03-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386111060 Melissa Marie Dixon Psychologist Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 2018-10-31
1366965618 Ashley Stuart Psychologist 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 2017-07-19
1487945135 Justin C Wheeler Pediatrics 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 2011-04-29
1154612117 Dana Boucek Pediatrics 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 2011-04-26
1285959502 Anna Katherine Eyre Ermarth Pediatrics 81 Mario Capecchi, Salt Lake City, UT 84113 2010-03-30
1457682072 Elizabeth K Cho Nurse Practitioner 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 2010-01-21
1528290848 Nancy Crandell Brown Nurse Practitioner 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 2009-08-20
1679708481 Primary Children's Medical Center General Acute Care Hospital 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 2009-05-22
1467697235 Tara Hook Physical Therapist 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 2008-12-09
1144474768 Jennifer K Workman Pediatrics 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 2008-11-10
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Taxonomy Information

Taxonomy Code 207RI0011X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Interventional Cardiology

Taxonomy Definition

An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine)

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386272755 Advanced Vein and Vascular of Salt Lake City LLC Internal Medicine 6321 S Redwood Rd Ste 102, Salt Lake City, UT 84123-6799 2020-03-31
1114361136 Lee Anthony Linstroth Internal Medicine 30 N 1900 E, Room 4c104, Salt Lake City, UT 84132-0002 2013-04-21
1437446168 Mountainstar Cardiology St Marks LLC Internal Medicine 1160 E 3900 S, Ste. 2000, Salt Lake City, UT 84124-1202 2011-07-01
1770720534 Zubair Cardiovascular Inc Internal Medicine 82 South 1100 East, Suite 402, Salt Lake City, UT 84102 2009-01-15
1629221841 Eric M Lindley Internal Medicine University of Utah, Salt Lake City, UT 84132-0001 2008-10-31
1255591194 Vamsee Mohan Yaganti Internal Medicine 1160 E 3900 S Ste 2000, Salt Lake City, UT 84124-1236 2008-06-13
1154538148 Anwar Tandar Internal Medicine 30 N 1900 E, University of Utah Hospital, Salt Lake City, UT 84132-0002 2007-05-17
1134219769 William Harvey Barry Internal Medicine 50 N Medical Dr, Cardiology Division, Salt Lake City, UT 84132-0001 2006-10-13
1922058064 Cardiovascular Consultants of Utah PC Internal Medicine 24 S 1100 E, Suite 304, Salt Lake City, UT 84102-1500 2006-05-11

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1700490133 Advanced Vein and Vascular of Northern Utah LLC Internal Medicine 810 S 100 W Ste 120, Logan, UT 84321-5845 2020-09-02
1326679952 Advanced Vein and Vascular of Southern Utah LLC Internal Medicine 1251 Northfield Rd # 103, Cedar City, UT 84721-8622 2020-02-02
1407851488 Tareq S Harb Internal Medicine 4403 Harrison Blvd Ste 3490, Ogden, UT 84403-3284 2005-06-16
1093329427 Advanced Vein and Vascular of Utah Valley LLC Internal Medicine 320 River Park Dr Ste 125, Provo, UT 84604-6065 2020-09-02
1396390316 American Heart and Vascular Institute PC Internal Medicine 5801 S Fashion Blvd Ste 120, Murray, UT 84107-8115 2019-08-06
1417283359 Canyon Crest Heart & Health L.L.C. Internal Medicine 11762 S State St, Draper, UT 84020-7155 2009-10-28
1235330382 Sohail Khan Internal Medicine 5405 S 500 E Ste 204, Ogden, UT 84405-7420 2007-05-29
1710010343 Arabindra Bahadur Katwal Internal Medicine 5405 S 500 E Ste 204, Ogden, UT 84405-7420 2007-03-13
1477698223 Ihc Health Services Inc Internal Medicine 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 2007-02-20
1689631913 Mark William Pulsipher Internal Medicine 1380 E Medical Center Dr, Suite 1500, St George, UT 84790-2123 2006-04-28
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Competitor

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City SALT LAKE CITY
Zip Code 84113

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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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