| Powell Medical Llc | |
|
107 N Greenfield Rd Ste 1 Mesa AZ 85205-7802 | |
| (480) 741-8041 | |
| Not Available |
| Full Name | Powell Medical Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 107 N Greenfield Rd Ste 1, Mesa, Arizona |
| Authorized Official Name and Position | Matthew Reed Powell (OWNER) |
| Authorized Official Contact | 4807418041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Powell Medical Llc 107 N Greenfield Rd Ste 1 Mesa AZ 85205-7802 Ph: (480) 741-8041 | Powell Medical Llc 107 N Greenfield Rd Ste 1 Mesa AZ 85205-7802 Ph: (480) 741-8041 |
| NPI Number | 1467144758 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 12/29/2023 |
| Medicare PECOS PAC ID | 3476908823 |
|---|---|
| Medicare Enrollment ID | O20231005000266 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467144758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Matthew Reed Powell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194110965 PECOS PAC ID: 8224343322 Enrollment ID: I20181024002718 |
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