Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 32542 | IA |
NPI | 1215991666 |
---|---|
Provider Name | Dr. Robert E Powers |
First Address | Sioux City, IA 51104-3755 |
Second Address | Sioux City, IA 51104-3755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174847 | (05) | IA |
E50369 | (02) |