Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | LT15664 | ND |
N | 207T00000X | Neurosurgeon | M-2045 | GU |
Y | 207T00000X | Neurosurgeon | ME50079 | FL |
NPI | 1114977477 |
---|---|
Provider Name | Dr. Neil Garrett Powell JR. |
First Address | Ocala, FL 34471-0478 |
Second Address | Ocala, FL 34471-0478 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2006 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3376809 | (05) | TN |
E89311 | (02) | TN |