Individual
JACK POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 532-7179
(770) 534-1312
Mailing address
1557 JANMAR RD, SNELLVILLE, GA 30078-5686
(678) 344-8900
(678) 666-5201
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN202066
GA
Other
Enumeration date
10/19/2015
Last updated
09/04/2019
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