Provider Demographics
NPI:1427020619
Name:STEVEN POWELL, MD, PA
Entity Type:Organization
Organization Name:STEVEN POWELL, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-732-0339
Mailing Address - Street 1:2910 SE 3RD CT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0485
Mailing Address - Country:US
Mailing Address - Phone:352-732-0339
Mailing Address - Fax:352-732-3715
Practice Address - Street 1:2910 SE 3RD CT
Practice Address - Street 2:SUITE A
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0485
Practice Address - Country:US
Practice Address - Phone:352-732-0339
Practice Address - Fax:352-732-3715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-02
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME46230207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCG7408OtherRAILROAD MEDICARE GROUP #
FL10D0272724OtherCLIA #
FLK1373Medicare ID - Type UnspecifiedMEDICARE GROUP #