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General NPI Number Information
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NPI Number | 1598095069
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Entity Type | Organization
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Legal Business Name | POWELL ORTHOPEDICS, PA
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Dates
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Enumeration Date | 01/06/2010
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1450 E ZION RD STE 6&10
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5041
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Country | US
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Telephone | 479-582-4647
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Fax | 479-582-4660
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Provider Business Mailing Address
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Address Line | PO BOX 9688
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-0030
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Country | US
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Telephone | 479-582-4647
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Fax | 479-582-4660
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK WILSON POWELL
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Credential | MD
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Telephone | 479-582-4647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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