Powell, Charles Randall

Powell, Charles Randall is an individual health care provider with primary practice located at 535 Barnhill Dr. , Indianapolis IN 46202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Powell, Charles Randall can be contacted via phone (317) 274-4622.

Contact Information

Primary practice address
535 Barnhill Dr. Indianapolis IN 46202
Phone: (317) 274-4622
Fax: (317) 274-0174
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 125044893 Illinois
Allopathic & Osteopathic Physicians / Urology 208800000X 37723 Iowa
Allopathic & Osteopathic Physicians / Urology 208800000X 01066313A Indiana

Profile Details

NPI number 1013125871
LBN Legal business name Powell, Charles Randall
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2007
Last updated Jan 6th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013125871 NPPES
Indiana MEDICAID 200950830

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