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NPI Code Detail

MEDICARE: JAMES A POWELL PT

MEDICARE: JAMES A POWELL PT
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
1225100000XPhysical Therapist000582WV
2225100000XPhysical Therapist003806OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356397012
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES A POWELL PT
Provider Business Mailing Address
First Line : 1851 N PLEASANTS HWY
Second Line :
City : SAINT MARYS
State : WV
Zip : 26170-8511
Country : US
Telephone Number : 304-684-2248
Fax Number : 304-684-2250
Provider Business Practice Location Address
First Line : 1851 N PLEASANTS HWY
Second Line :
City : SAINT MARYS
State : WV
Zip : 26170-8511
Country : US
Telephone Number : 304-684-2248
Fax Number : 304-684-2250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 07/09/2008

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