Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 4276 | KS |
NPI | 1043346943 |
---|---|
Provider Name | Dr. Norman W. Powers |
First Address | Emporia, KS 66801-5367 |
Second Address | Emporia, KS 66801-5367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116755 | BLUE CROSS BLUE SHIELD (01) | KS |