Individual
DR. OTIS SAMUEL POWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 CLEVELAND AVE SW STE 500, ATLANTA, GA 30315-7115
(404) 755-2291
(404) 755-5377
Mailing address
777 CLEVELAND AVE SW STE 500, ATLANTA, GA 30315-7115
(404) 755-2291
(404) 755-5377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
025814
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00309845G
—
GA
Enumeration date
07/20/2006
Last updated
11/05/2024
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