Healthcare Provider Details

I. General information

NPI: 1235556366
Provider Name (Legal Business Name): FORREST POWERS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE STE 1550
ATLANTA GA
30308-2253
US

IV. Provider business mailing address

12155 EDENWILDE DR
ROSWELL GA
30075-7150
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4366
  • Fax:
Mailing address:
  • Phone: 678-773-9293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number83067
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: