Provider Demographics
NPI:1689985087
Name:SILLS-POWELL, JAMES DAVID (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVID
Last Name:SILLS-POWELL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1776 CROSSWINDS DR
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-4832
Mailing Address - Country:US
Mailing Address - Phone:314-735-5197
Mailing Address - Fax:314-338-3495
Practice Address - Street 1:1776 CROSSWINDS DR
Practice Address - Street 2:
Practice Address - City:WENTZVILLE
Practice Address - State:MO
Practice Address - Zip Code:63385-4832
Practice Address - Country:US
Practice Address - Phone:314-735-5197
Practice Address - Fax:314-338-3495
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012040658213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4661001Medicare UPIN
MOMA2878003Medicare UPIN