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Contact Information

SHANE K POWELL, MD
210 W 300 N 75-3
ROOSEVELT, UT84066
 Phone: 435-722-3971
 Fax: 435-722-6104
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for SHANE K POWELL · (Male)

NPI Number 1750342655
Status Active
Credentials MD
Entity Individual
Enumeration date 03/30/2006
Last updated 06/20/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • UT License # 3083961205
  • UT Medicaid D3889
Hospital affiliation(s)
  • UINTAH BASIN MEDICAL CENTER - (Acute Care)
    250 WEST 300 NORTH (75-2)
    ROOSEVELT, UT 84066
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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