Organization
RONALD G POWELL MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELENIE NACHIMSON (CREDENTIALING SPECIALIST)
(405) 775-9350
Entity
Organization
Contact information
Practice address
920 STANTON L YOUNG BLVD # WP1140, OKLAHOMA CITY, OK 73104-5036
(405) 271-4351
(405) 271-8695
Mailing address
PO BOX 26901, WP1140, OKLAHOMA CITY, OK 73126
(405) 271-4351
(405) 271-8695
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15320
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050052959
MEDICARE RR
OK
01
—
4483804
AETNA
OK
Enumeration date
09/23/2005
Last updated
09/21/2018
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