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NPI Code Detail

MEDICARE: MYRON POWELSON III MD

MEDICARE: MYRON POWELSON III MD
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
1207L00000XAnesthesiology Physician35045748OH
2207L00000XAnesthesiology Physician35.045748OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1050056064OTHERRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1588659650
Entity Type Code : Individual
Provider Name (Legal Business Name) : MYRON POWELSON III MD
Provider Business Mailing Address
First Line : 945 BETHESDA DRIVE
Second Line : 200B
City : ZANESVILLE
State : OH
Zip : 43701-1406
Country : US
Telephone Number : 740-455-4937
Fax Number : 740-455-4931
Provider Business Practice Location Address
First Line : 2951 MAPLE AVENUE
Second Line :
City : ZANESVILLE
State : OH
Zip : 43701-1406
Country : US
Telephone Number : 513-672-3309
Fax Number : 513-672-3323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 06/16/2009

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