Healthcare Provider Details

I. General information

NPI: 1831202241
Provider Name (Legal Business Name): BERNARD J POWERS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: BERNARD J POWERS M.D

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 09/28/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 RIDGEGATE PKWY STE 312
LONE TREE CO
80124-5520
US

IV. Provider business mailing address

10103 RIDGEGATE PKWY STE 312
LONE TREE CO
80124-5520
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-8888
  • Fax: 303-790-2567
Mailing address:
  • Phone: 303-788-8888
  • Fax: 303-790-2567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number28046
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: