Powell, Jimmy Lee

Powell, Jimmy Lee is an sole proprietor health care provider with primary practice located at 1411 W 4Th St , Coffeyville KS 67337-3300. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Powell, Jimmy Lee can be contacted via phone (620) 251-0050.

Contact Information

Primary practice address
1411 W 4Th St Coffeyville KS 67337-3300
Phone: (620) 251-0050
Fax: (620) 251-0050
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X

Profile Details

NPI number 1760450449
LBN Legal business name Powell, Jimmy Lee
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2006
Last updated Feb 25th, 2015 - about 9 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 1760450449 NPPES
Kansas MEDICAID 100095230A
Kansas Other OP7674

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