Provider Demographics
NPI:1578553574
Name:POWERS, JAMES P (DO, PA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:P
Last Name:POWERS
Suffix:
Gender:M
Credentials:DO, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 COFFEE POT BLVD. N.E.
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704
Mailing Address - Country:US
Mailing Address - Phone:727-738-5900
Mailing Address - Fax:
Practice Address - Street 1:5413 US HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652
Practice Address - Country:US
Practice Address - Phone:727-738-5900
Practice Address - Fax:727-738-5740
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8433207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263347702Medicaid
FL263347701Medicaid
FL263347701Medicaid
FL263347702Medicaid
FLH54618Medicare UPIN
FL06335GMedicare ID - Type UnspecifiedINDIVIDUAL
FLK6121Medicare PIN