MEDICARE: JEANNETTE POWER 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
1	207R00000X	Internal Medicine Physician	25814	OK

General Provider Information

NPI Number	:	1295927234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNETTE POWER M.D.

Provider Business Mailing Address
First Line	:	4502 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-9923
Country	:	US
Telephone Number	:	918-744-2548
Fax Number	:	918-744-2531

Provider Business Practice Location Address
First Line	:	4502 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-9923
Country	:	US
Telephone Number	:	918-744-2548
Fax Number	:	918-744-2531

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

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	08/20/2007

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