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NPI 1578591988

NPI 1578591988 : JOHN D POWELL M.D. : LENOIR, NC

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General NPI Number Information
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    NPI Number           |    1578591988
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    Entity Type          |    Individual 
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    Provider Name        |    JOHN D POWELL M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/28/2006
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    Last Update Date     |    03/17/2021
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Provider Practice Location Address
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    Address Line         |    1731 CONNELLY SPRINGS RD 
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    City                 |    LENOIR
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    State                |    NC
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    Zip                  |    28645-7827
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    Country              |    US
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    Telephone            |    828-757-6300
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    Fax                  |    828-757-6324
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Provider Business Mailing Address
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    Address Line         |    321 MULBERRY ST SW MEDICAL STAFF SERVICES
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    City                 |    LENOIR
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    State                |    NC
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    Zip                  |    28645-5720
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    Country              |    US
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    Telephone            |    828-757-5965
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    Fax                  |    828-757-5104
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    96-01440
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    License Number State |    NC
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