Provider Demographics
NPI:1558465179
Name:POWERS, LAILA WILBER (MD)
Entity Type:Individual
Prefix:
First Name:LAILA
Middle Name:WILBER
Last Name:POWERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 CENTRAL PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8813
Mailing Address - Country:US
Mailing Address - Phone:970-879-1322
Mailing Address - Fax:970-870-1223
Practice Address - Street 1:1024 CENTRAL PARK DRIVE
Practice Address - Street 2:
Practice Address - City:STEAMBOAT SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80487-8813
Practice Address - Country:US
Practice Address - Phone:970-879-1322
Practice Address - Fax:970-870-1223
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO31391207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01313915Medicaid
F41011Medicare UPIN
CO01313915Medicaid