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NPI Code Detail

MEDICARE: THOMAS WILLIAM POWERS M.D.

MEDICARE: THOMAS WILLIAM POWERS M.D.
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
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianA116516CA
2390200000XStudent in an Organized Health Care Education/Training Program
3207X00000XOrthopaedic Surgery PhysicianA116516CA

General Provider Information

NPI Number : 1174755789
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS WILLIAM POWERS M.D.
Provider Business Mailing Address
First Line : 3400 DATA DR
Second Line : CREDENTIALING
City : RANCHO CORDOVA
State : CA
Zip : 95670-7956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8220 WYMARK DR
Second Line :
City : ELK GROVE
State : CA
Zip : 95757-6297
Country : US
Telephone Number : 916-667-0600
Fax Number : 916-683-0232
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2009
Last Update Date : 12/17/2021

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