Provider Demographics
NPI:1487685616
Name:POWELL, RONALD JONES (MD)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JONES
Last Name:POWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1163
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27331-1163
Mailing Address - Country:US
Mailing Address - Phone:919-775-3020
Mailing Address - Fax:919-774-1044
Practice Address - Street 1:3072 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-9644
Practice Address - Country:US
Practice Address - Phone:919-775-3020
Practice Address - Fax:919-775-1044
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30705207R00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8968592Medicaid
NC68592OtherBLUECROSS BLUESHIELD
NC212631Medicare ID - Type Unspecified
NC8968592Medicaid