Individual
DR. LISA G POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3850 S NATIONAL AVE, SUITE 400, SPRINGFIELD, MO 65807-5287
(417) 269-6850
(417) 269-5830
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-6850
(417) 269-5830
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R5695
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18402
BLUE CROSS OF MO
—
05
—
202409025
—
MO
Enumeration date
09/20/2006
Last updated
01/10/2013
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