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NPI Code Detail

MEDICARE: JAMES A POWELL

MEDICARE: JAMES A POWELL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist000582WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558584573
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES A POWELL
Provider Business Mailing Address
First Line : 1851 N PLEASANTS HWY
Second Line :
City : SAINT MARYS
State : WV
Zip : 26170-8511
Country : US
Telephone Number : 304-684-2248
Fax Number : 304-684-2250
Provider Business Practice Location Address
First Line : 1851 N PLEASANTS HWY
Second Line :
City : SAINT MARYS
State : WV
Zip : 26170-8511
Country : US
Telephone Number : 304-684-2248
Fax Number : 304-684-2250
Authorized Official
Title or Position : OWNER
Name : JAMES A POWELL
Credential : PT
Telephone Number : 304-684-2248
Provider Enumeration Date : 04/10/2007
Last Update Date : 06/17/2008

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