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Individual

BRIAN KEITH POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
12420 130TH AVE, LARGO, FL 33774-1919
(727) 824-8181
(727) 587-7739
Mailing address
PO BOX 10549, ST PETERSBURG, FL 33733-0549
(727) 824-8181

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
5101016675
MI
207Q00000X
Family Medicine Physician
Primary
OS12134
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008859000
FL
01
01019633
HEALTH PLUS OF MICHIGAN
01
080G310660
BCBS OF MICHIGAN
01
1053717
MCLAREN HEALTH PLAN/HEALTH ADVANTAGE
01
1144432402
MOLINA HEALTHCARE OF MICHIGAN
05
1144432402
MI
01
176125
GREAT LAKES HEALTH PLAN OF MI
01
381908328
PRIORITY HEALTH OF MICHIGAN
01
381908328-435
CARE SOURCE OF MICHIGAN
01
54684
HEALTH PLAN OF MICHIGAN
Enumeration date
05/07/2007
Last updated
11/06/2014
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