Provider Demographics
NPI:1720257819
Name:WILLIAM R POWERS M.D. INC.
Entity Type:Organization
Organization Name:WILLIAM R POWERS M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-659-3395
Mailing Address - Street 1:195 E BROAD ST
Mailing Address - Street 2:P.O. BOX 236
Mailing Address - City:LYONS
Mailing Address - State:IN
Mailing Address - Zip Code:47443-9502
Mailing Address - Country:US
Mailing Address - Phone:812-659-3395
Mailing Address - Fax:812-659-3432
Practice Address - Street 1:195 E BROAD ST
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:IN
Practice Address - Zip Code:47443-9502
Practice Address - Country:US
Practice Address - Phone:812-659-3395
Practice Address - Fax:812-659-3432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100124550Medicaid
IN193090Medicare PIN
IN100124550Medicaid