Healthcare Provider Details

I. General information

NPI: 1366021214
Provider Name (Legal Business Name): GREGORY LOUIS POWER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

705 RILEY HOSPITAL DR
INDIANAPOLIS IN
46202-5109
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-4443
  • Fax: 319-356-8170
Mailing address:
  • Phone: 317-944-4034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD-53040
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: