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Individual

JASON POWERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3 LIONS DR, NORTH LIBERTY, IA 52317-9575
(319) 626-5680
(319) 626-5687
Mailing address
3 LIONS DR, NORTH LIBERTY, IA 52317-9575
(319) 626-5680
(319) 626-5687

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34582
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1285437
IA
01
34574
WELLMARK BCBS
IA
01
P00028025
RR MEDICARE
IA
Enumeration date
10/06/2005
Last updated
09/17/2009
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