Individual
DR. DOUGLAS L POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
50 N MEDICAL DR, SALT LAKE CITY, UT 84132-1100
(801) 581-2955
Mailing address
PO BOX 841052, LOS ANGELES, CA 90084-1052
(801) 587-6340
(801) 587-6346
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2764261205
UT
207NS0135X
Procedural Dermatology Physician
2764261205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002082671
—
NV
05
—
806051301
—
ID
05
—
870468377001
—
UT
05
—
MD120UT
—
AK
Enumeration date
09/15/2006
Last updated
04/21/2023
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