Powell, Shane K

Powell, Shane K is an sole proprietor health care provider with primary practice located at 210 W 300 N 75-3 , Roosevelt UT 84066. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Powell, Shane K can be contacted via phone (435) 722-3971.

Contact Information

Primary practice address
210 W 300 N 75-3 Roosevelt UT 84066
Phone: (435) 722-3971
Fax: (435) 722-6104
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 3083961205 Utah

Profile Details

NPI number 1750342655
LBN Legal business name Powell, Shane K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 30th, 2006
Last updated Jun 20th, 2017 - about 8 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 1750342655 NPPES
Utah MEDICAID D3889

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