MEDICARE: DR. THOMAS STEPHEN POWELL III M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	82709	GA
2	207Q00000X	Family Medicine Physician	082709	GA
3	207Q00000X	Family Medicine Physician	29353	MS

General Provider Information

NPI Number	:	1487036224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS STEPHEN POWELL III M.D.

Provider Business Mailing Address
First Line	:	878 VIRGINIA AVE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-3616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 BRIARCLIFF RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-2618
Country	:	US
Telephone Number	:	404-875-6456
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2015
Last Update Date	:	11/26/2025

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