Provider Demographics
NPI:1497778633
Name:POWELL, JAMES SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SCOTT
Last Name:POWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 2205
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2205
Mailing Address - Country:US
Mailing Address - Phone:606-324-7737
Mailing Address - Fax:606-324-7408
Practice Address - Street 1:1450 DIEDERICH BLVD
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KY
Practice Address - Zip Code:41169-1719
Practice Address - Country:US
Practice Address - Phone:606-324-7737
Practice Address - Fax:606-324-7408
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY25181207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64251812Medicaid
KY0206501Medicare ID - Type Unspecified
KYC69276Medicare UPIN