Powell, Jeffrey Haidon

Powell, Jeffrey Haidon is an individual health care provider with primary practice located at 2320 S Main St , Maryville MO 64468-3622. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Powell, Jeffrey Haidon can be contacted via phone (660) 582-4022.

Contact Information

Primary practice address
2320 S Main St Maryville MO 64468-3622
Phone: (660) 582-4022
Fax: (660) 582-4038
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T02187 Missouri

Profile Details

NPI number 1679543995
LBN Legal business name Powell, Jeffrey Haidon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Oct 11th, 2007 - 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 1679543995 NPPES
Missouri Other 3974310001 CIGNA MEDICARE

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