Provider Demographics
NPI:1699811919
Name:ALAN E POWELL, MD, PC
Entity type:Organization
Organization Name:ALAN E POWELL, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:816-373-4001
Mailing Address - Street 1:17221 E 23RD ST S STE 210
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1822
Mailing Address - Country:US
Mailing Address - Phone:816-373-4001
Mailing Address - Fax:816-373-0488
Practice Address - Street 1:17221 E 23RD ST S STE 210
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1822
Practice Address - Country:US
Practice Address - Phone:816-373-4001
Practice Address - Fax:816-373-0488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR3870208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty