Individual
DR. JESSE WILLIAM POWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
129 N WASHINGTON ST, SUMTER, SC 29150-4949
(803) 112-9163
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
LL28146
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281466
—
SC
Enumeration date
05/22/2006
Last updated
08/07/2013
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