Individual
DR. JENNIFER S. POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
120 HOSPITAL DR, SUITE 100, LEBANON, MO 65536-9238
(417) 533-6751
(417) 533-6755
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006107611
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
# PENDING
—
MO
Enumeration date
08/31/2006
Last updated
05/09/2013
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