1336223064 NPI number — DR. MICHELLE LEIGH EHRLICH POWERS MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336223064 NPI number — DR. MICHELLE LEIGH EHRLICH POWERS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POWERS
Provider First Name:
MICHELLE
Provider Middle Name:
LEIGH EHRLICH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EHRLICH
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1336223064
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/17/2007
NPI Reactivation Date:
08/06/2007

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 N LEE AVE
Provider Second Line Business Mailing Address:
DEPT. OF PATHOLOGY
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73102-1036
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-752-3828
Provider Business Mailing Address Fax Number:
405-270-7567

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 N LEE AVE
Provider Second Line Business Practice Location Address:
DEPT. OF PATHOLOGY
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73102-1036
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-752-3828
Provider Business Practice Location Address Fax Number:
405-270-7567
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0102X , with the licence number:  27447 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0102X , with the licence number: N1839 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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