Basic Information
| Provider Information | |||||||||
| NPI: | 1386628923 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OWENSBY | ||||||||
| FirstName: | CHARLTON | ||||||||
| MiddleName: | NORMAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2240 REMOUNT RD | ||||||||
| Address2: | |||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280544725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7046715311 | ||||||||
| FaxNumber: | 7046715308 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 COURT DR | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | GASTONIA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280542140 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048343070 | ||||||||
| FaxNumber: | 7048343073 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2083X0100X | 29362 | NC | Y | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine |
No ID Information.