MEDICARE: WILLIAM RAY POWERS 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
1	207Q00000X	Family Medicine Physician	01021214A	IN

Other Identifiers

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

General Provider Information

NPI Number	:	1659372860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM RAY POWERS MD

Provider Business Mailing Address
First Line	:	195 E BROAD ST
Second Line	:	PO BOX 236
City	:	LYONS
State	:	IN
Zip	:	47443
Country	:	US
Telephone Number	:	812-659-3353
Fax Number	:

Provider Business Practice Location Address
First Line	:	195 E BROAD ST
Second Line	:
City	:	LYONS
State	:	IN
Zip	:	47443-0236
Country	:	US
Telephone Number	:	812-659-3353
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	06/26/2012

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