MEDICARE: ROBERT ALAN POWELL DO

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	207Q00000X	Family Medicine Physician	1118	NE

General Provider Information

NPI Number	:	1912261033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ALAN POWELL DO

Provider Business Mailing Address
First Line	:	MARTIN ARMY COMMUNITY HOSPITAL
Second Line	:	6600 VAN AALST BLVD
City	:	FORT MOORE
State	:	GA
Zip	:	31905
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	MARTIN ARMY COMMUNITY HOSPITAL
Second Line	:	6600 VAN AALST BLVD
City	:	FORT MOORE
State	:	GA
Zip	:	31905-0000
Country	:	US
Telephone Number	:	303-903-0158
Fax Number	:

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

Provider Enumeration Date	:	07/03/2012
Last Update Date	:	07/30/2024

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