1528052248 NPI number — DR. JAMES A. POWELL, JR., D.C., P.C.

Table of content: (NPI 1528052248)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528052248 NPI number — DR. JAMES A. POWELL, JR., D.C., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. JAMES A. POWELL, JR., D.C., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
POWELL CHIROPRACTIC CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528052248
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1444 TIFT AVE N
Provider Second Line Business Mailing Address:
STE B
Provider Business Mailing Address City Name:
TIFTON
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31794-4618
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
229-382-3210
Provider Business Mailing Address Fax Number:
229-382-3213

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1444 TIFT AVE N
Provider Second Line Business Practice Location Address:
STE B
Provider Business Practice Location Address City Name:
TIFTON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31794-4618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
229-382-3210
Provider Business Practice Location Address Fax Number:
229-382-3213
Provider Enumeration Date:
09/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
POWELL
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
AMBUS
Authorized Official Title or Position:
OWNER/PRESIDENT
Authorized Official Telephone Number:
229-382-3210

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  7050 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com