Individual
DR. MELISSA A POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
410 N STATE OF FRANKLIN RD, SUITE 130, JOHNSON CITY, TN 37604-6971
(423) 431-2477
(423) 431-2478
Mailing address
410 N STATE OF FRANKLIN RD, SUITE 130, JOHNSON CITY, TN 37604-6971
(423) 431-2477
(423) 431-2478
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
16746
WV
208600000X
Surgery Physician
31797
TN
2086S0102X
Surgical Critical Care Physician
Primary
0101236366
VA
2086S0102X
Surgical Critical Care Physician
31797
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053407809
—
NC
05
—
1053407809
—
VA
05
—
3004661000
—
WV
01
—
P00358617
RAILROAD MEDICARE
WV
05
—
Q002848
—
TN
Enumeration date
10/05/2006
Last updated
02/08/2023
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