Individual
DR. KENNETH ANGUS POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2700 RIVERSIDE AVE STE 2, JACKSONVILLE, FL 32205-8233
(904) 265-7755
(904) 265-7754
Mailing address
705 WELLS RD STE 300, ORANGE PARK, FL 32073-2982
(904) 282-6331
(904) 619-1080
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
OS10548
FL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
OS10548
FL
208VP0014X
Interventional Pain Medicine Physician
OS 10548
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001324200
—
FL
Enumeration date
03/28/2007
Last updated
08/31/2022
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