Individual
JORDAN ILAH POWERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1125 N COLLEGE AVE # SLOT100, FAYETTEVILLE, AR 72703-1908
(479) 713-8310
Mailing address
934 N GASKILL ST, HUNTSVILLE, AR 72740-8903
(479) 738-5500
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-14023
AR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/09/2018
Last updated
04/28/2021
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