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Individual

TALESSA POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
300 E BOYD AVE, SUITE 100, GREENFIELD, IN 46140-2816
(317) 462-5252
(317) 462-8010
Mailing address
300 E BOYD AVE, SUITE 100, GREENFIELD, IN 46140-2816
(317) 462-5252
(317) 462-8010

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01049053
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200270310
IN
Enumeration date
10/03/2006
Last updated
03/29/2021
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