Provider Demographics
NPI:1194759779
Name:POWERS, J MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:MICHAEL
Last Name:POWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GUERNSEY ANESTHESIA ASSOCIATES, INC.
Mailing Address - Street 2:PO BOX 951523
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193
Mailing Address - Country:US
Mailing Address - Phone:800-270-2955
Mailing Address - Fax:440-247-4331
Practice Address - Street 1:SOUTHEASTERN OHIO REGIONAL MEDICAL CENTER
Practice Address - Street 2:1341 CLARK ST
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725
Practice Address - Country:US
Practice Address - Phone:740-439-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111698207L00000X
OH35.073673207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2062539Medicaid
OH0866901Medicare ID - Type Unspecified