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Individual

JEROLD L POWERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10752 N 89TH PL, B-121, SCOTTSDALE, AZ 85260-6730
(480) 661-0030
(480) 661-9601
Mailing address
10752 N 89TH PL, B-121, SCOTTSDALE, AZ 85260-6730
(480) 661-0030
(480) 661-9601

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
11237
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AZ0027610
BLUE CROSS ID
AZ
Enumeration date
03/29/2006
Last updated
12/08/2011
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