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Individual

DR. JAMES EDSON POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
212 N PRAIRIE ST, FLANDREAU, SD 57028-1243
(605) 997-2471
(605) 997-2418
Mailing address
212 N PRAIRIE ST, FLANDREAU, SD 57028-1243
(605) 997-2471
(605) 997-2418

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2098
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0139311
IA
01
080015869
RAILROAD MEDICARE
IA
01
13931
WELLMARK BC/BS
IA
05
5613130
SD
Enumeration date
09/26/2005
Last updated
09/26/2008
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