Basic Information
| Provider Information | |||||||||
| NPI: | 1346251881 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HITT | ||||||||
| FirstName: | OWEN | ||||||||
| MiddleName: | K | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 776351 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606776351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025889490 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 210 E GRAY ST | ||||||||
| Address2: | SUITE 604 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402023900 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026295633 | ||||||||
| FaxNumber: | 5026295580 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2006 | ||||||||
| LastUpdateDate: | 03/12/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 14462 | KY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 000000514477 | 01 | KY | ANTHEM - NOTC (B&J) | OTHER | 082291 | 01 | KY | SIHO - NOTC (B&J) | OTHER | 2547979 | 01 | KY | CIGNA - NOTC (B&J) | OTHER | P00449263 | 01 | KY | RAILROAD MEDICARE | OTHER | 000057121D | 01 | KY | HUMANA - NOTC (B&J) | OTHER | 64144629 | 05 | KY | MEDICAID | 2859402000 | 01 | KY | PASSPORT ADVANTAGE - NOTC (B&J) | OTHER | 100323940 | 05 | IN | MEDICAID | 50016001 | 01 | KY | PASSPORT - NOTC (B&J) | OTHER | 50018174 | 01 | KY | PASSPORT | OTHER |