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Contact Information

THEO H POWELL, MD
495 SW RAMSEY AVE
GRANTS PASS, OR97527
 Phone: 541-476-6644
 Fax: 541-472-5673
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for THEO H POWELL · (Male)

NPI # 1164427951
Status Active
Credentials MD
Entity Individual
Enumeration date 06/17/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • OR License # MD11637
  • OR Medicaid 074527
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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