Individual
MRS. JILL ANITA POWNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
22 19TH ST SE, WATERTOWN, SD 57201-3938
(605) 753-3937
(605) 753-0472
Mailing address
22 19TH ST SE, WATERTOWN, SD 57201-3938
(057) 533-9376
(605) 753-0472
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002458
IA
152W00000X
Optometrist
Primary
T681
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421499499
—
IA
01
—
4977608
BCBS SD
SD
01
—
S112121
MEDICARE PIN
SD
Enumeration date
06/30/2009
Last updated
09/26/2023
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