Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | DO180017 | OR |
N | 207Q00000X | Family Doctor | DO180017 | OR |
NPI | 1285779439 |
---|---|
Provider Name | Dr. William P Powell |
First Address | Ashland, OR 97520-1821 |
Second Address | Ashland, OR 97520-1821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 30/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500717449 | (05) | OR |