Healthcare Provider Details

I. General information

NPI: 1780632695
Provider Name (Legal Business Name): JAMES O. POWELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

840 MONTCLAIR RD SUITE 722
BIRMINGHAM AL
35213-1920
US

IV. Provider business mailing address

840 MONTCLAIR RD SUITE 722
BIRMINGHAM AL
35213-1920
US

V. Phone/Fax

Practice location:
  • Phone: 205-591-2311
  • Fax: 205-592-3531
Mailing address:
  • Phone: 205-591-2311
  • Fax: 205-592-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number4237
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: