Provider Demographics
NPI:1285820993
Name:CARL F POWERS, O.D. PLLC
Entity Type:Organization
Organization Name:CARL F POWERS, O.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:F
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:231-838-2320
Mailing Address - Street 1:614 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2724
Mailing Address - Country:US
Mailing Address - Phone:231-838-2320
Mailing Address - Fax:
Practice Address - Street 1:614 HOWARD ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2724
Practice Address - Country:US
Practice Address - Phone:231-838-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003585152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU25868Medicare UPIN