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Individual

KEVIN J POWERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1791 W 3RD ST, BLOOMINGTON, IN 47404-5029
(812) 333-4422
(812) 333-6698
Mailing address
PO BOX 1981, BLOOMINGTON, IN 47402-1981
(812) 333-4422
(812) 333-6698

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
07000616
IN
213E00000X
Podiatrist
Primary
07000615A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100194880A
IN
Enumeration date
07/07/2005
Last updated
09/14/2023
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