MEDICARE: DR. DAVID W POWELL DPM

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	213E00000X	Podiatrist	07000467	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000042550	OTHER	IN	ANTHEM PIN #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346243078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID W POWELL DPM

Provider Business Mailing Address
First Line	:	4640 W LLOYD EXPY
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47712-6517
Country	:	US
Telephone Number	:	812-422-4336
Fax Number	:	812-421-0994

Provider Business Practice Location Address
First Line	:	4640 W LLOYD EXPY
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47712-6517
Country	:	US
Telephone Number	:	812-422-4336
Fax Number	:	812-421-0994

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

Provider Enumeration Date	:	05/26/2005
Last Update Date	:	10/10/2007

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