Powell, Timothy J
Powell, Timothy J is an individual health care provider with primary practice located at 1937 W Harvard Ave , Roseburg OR 97471-2720. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Powell, Timothy J can be contacted via phone (541) 677-7200.Contact Information
Primary practice address
1937 W Harvard Ave
Roseburg OR 97471-2720
Phone: (541) 677-7200
Fax: (541) 229-3309
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD12182 | Oregon |
Profile Details
| NPI number | 1689647844 |
|---|---|
| LBN Legal business name | Powell, Timothy J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Jun 9th, 2020 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689647844 | NPPES |
| Oregon | Other | J406423 | IND PACSOURCE |
| Oregon | Other | 080120961 | IND PACSOURCE |
| Oregon | MEDICAID | 065847 | IND PACSOURCE |
| Oregon | Other | 000188005 | IND PACSOURCE |
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