Individual
DR. ROBERT WILLIAM POWELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 PIKE ST, SHINNSTON, WV 26431-1405
(304) 592-1500
(304) 592-1343
Mailing address
401 PIKE ST, SHINNSTON, WV 26431-1405
(304) 592-1500
(304) 592-1343
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
763OD
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150761000
—
WV
Enumeration date
07/12/2006
Last updated
02/23/2012
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