Powell, Jake Richard

Powell, Jake Richard is an individual health care provider with primary practice located at 1001 E Superior St Suite L401, Duluth MN 55802-2207. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Powell, Jake Richard can be contacted via phone (218) 249-7960.

Contact Information

Primary practice address
1001 E Superior St Suite L401 Duluth MN 55802-2207
Phone: (218) 249-7960
Fax: (218) 249-7997
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 43769 Minnesota
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 43769 Minnesota

Profile Details

NPI number 1043260524
LBN Legal business name Powell, Jake Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Dec 4th, 2020 - about 4 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 1043260524 NPPES
Minnesota MEDICAID 478948200

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