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General NPI Number Information
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NPI Number | 1477013381
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Entity Type | Individual
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Provider Name | CHARLES HILL POWELL III PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 07/26/2019
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Provider Practice Location Address
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Address Line | 5779 CREEKWOOD PARK BLVD
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City | LENOIR CITY
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State | TN
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Zip | 37772-1203
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Country | US
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Telephone | 865-988-6330
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 440332
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City | NASHVILLE
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State | TN
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Zip | 37244-0332
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Country | US
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Telephone | 865-670-6199
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Fax | 865-670-6198
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA0000003764
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3764
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License Number State | TN
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