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Mr. Jimmy Lee Powell
Optician in Coffeyville, Kansas
NPI 1760450449

Jimmy Lee Powell is a Optician based in Coffeyville, KS and is specialized in Optician. Jimmy Lee Powell practices in Coffeyville, KS. The NPI Number for Jimmy Lee Powell is 1760450449 and holds a License No. (Kansas).

The current practice location address for Jimmy Lee Powell is 1411 W 4Th St, Coffeyville, KS and can be reached out via phone at 620-251-0050 and via fax at 620-251-0050.

Location: 1411 W 4Th St, Coffeyville, KS, 67337-3300
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1760450449
Provider Name
Jimmy Lee Powell
Credential
Provider Entity Type
Individual
Gender
Male
Address
1411 W 4Th St, Coffeyville, KS, 67337-3300
Phone Number
620-251-0050
Fax Number
620-251-0050
Provider Enumeration Date
03/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100095230A 05 KS
OP7674 01 KS BLUE CROSS & BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
1411 W 4Th St
City
Coffeyville
State
Kansas
Zip
67337-3300
Phone Number
620-251-0050
Fax Number
620-251-0050
person
Provider Business Mailing Address Details
Address
1411 W 4Th St
City
Coffeyville
State
Kansas
Zip
67337-3300
Phone Number
620-251-0050
Fax Number
620-251-0050
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
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Definition
Definition to come...
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