Provider Demographics
NPI:1932410370
Name:POWERS, DAVID WESTON (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WESTON
Last Name:POWERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:WES
Other - Middle Name:
Other - Last Name:POWERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:225 MEDICAL CENTER DR STE 308
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-7915
Mailing Address - Country:US
Mailing Address - Phone:270-443-0777
Mailing Address - Fax:270-443-0999
Practice Address - Street 1:225 MEDICAL CENTER DR STE 308
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7915
Practice Address - Country:US
Practice Address - Phone:270-443-0777
Practice Address - Fax:270-443-0999
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS019162207R00000X
KY04431207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAOS019162OtherLICENSE