Organization
TERRY D POWELL RADIATION ONCOLOGIST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY DOUGLAS POWELL M.D. (PRESIDENT/OWNER)
(620) 252-1684
Entity
Organization
Contact information
Practice address
1400 W 4TH ST,, RADIATION ONCOLOGY DEPT, COFFEYVILLE, KS 67337
(620) 252-1684
(620) 252-1692
Mailing address
PO BOX 993, COFFEYVILLE, KS 67337-0993
(620) 252-1684
(620) 252-1692
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
04-14232
KS
2085R0203X
Therapeutic Radiology Physician
9106
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100196610B
—
KS
05
—
100200170B
—
OK
Enumeration date
02/01/2010
Last updated
02/01/2010
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