Powell, Jeffrey C

Powell, Jeffrey C is an individual health care provider with primary practice located at Us Hwy 491 North , Shiprock NM 87420. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Powell, Jeffrey C can be contacted via phone (505) 368-6401.

Contact Information

Primary practice address
Us Hwy 491 North Shiprock NM 87420
Fax: (505) 368-6431
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD00040293 Washington

Profile Details

NPI number 1194700674
LBN Legal business name Powell, Jeffrey C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2005
Last updated Jan 4th, 2008 - about 17 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 1194700674 NPPES
Arizona MEDICAID 714635
Arizona MEDICAID 31326021
Arizona MEDICAID 83872540

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