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Contact Information

JERRY R POWELL II, MD
1400 E 9TH ST
ROCHESTER, IN46975
 Phone: 574-224-1048
 Fax: 574-224-1103
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for JERRY R POWELL II · (Male)

NPI Number 1619958378
Status Active
Credentials MD
Entity Individual
Enumeration date 11/09/2005
Last updated 11/12/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01053633
  • IN License # 01053633A
  • IN Medicaid 200001940A
  • IN Medicaid 200231510
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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