John Robert Powell

Individual provider Active NPI Independent Duty Medical Technicians · Malmstrom Afb, MT

NPI 1154939643 · NPPES record last updated Jul 21, 2020

Key facts

NPI
1154939643
Entity type
Individual (NPI type 1)
Primary specialty
Independent Duty Medical Technicians 1710I1003X
Practice address
7300 N Perimeter Rd BLDG 2040
Malmstrom Afb, MT 59402-6701
Phone
(406) 731-4633
NPI assigned
Jul 21, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Yes

Addresses

Primary practice location

7300 N Perimeter Rd BLDG 2040
Malmstrom Afb, MT 59402-6701

Mailing address

6404 Magnolia Dr
Great Falls, MT 59405-6807
Phone (402) 212-0769

Other providers in Malmstrom Afb, MT

All providers in Malmstrom Afb, MT · Independent Duty Medical Technicians in Montana

Sources for this page

Verify at the official NPI Registry.