Healthcare Provider Details

I. General information

NPI: 1871089128
Provider Name (Legal Business Name): DAVID POWELL PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 THOMPSON STREET SUIE A
HENDERSONVILLE NC
28791-3410
US

IV. Provider business mailing address

800 N JUSTICE ST # 16
HENDERSONVILLE NC
28791-3410
US

V. Phone/Fax

Practice location:
  • Phone: 828-697-3232
  • Fax: 828-694-0125
Mailing address:
  • Phone: 828-694-8350
  • Fax: 828-694-7654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: