Individual
STELLA M POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2538
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2538
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
00026948
AL
2085R0202X
Diagnostic Radiology Physician
Primary
17106
MS
2085R0202X
Diagnostic Radiology Physician
39819
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00884849
—
MS
05
—
009936784
—
AL
05
—
2836971
—
OH
05
—
3810011689
—
WV
01
—
510-03463
BCBS AL
AL
05
—
7100041260
—
KY
01
—
P00338270
RR MEDICARE
—
01
—
P01687354
RR MEDICARE
MS
Enumeration date
05/19/2006
Last updated
11/28/2016
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