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Individual

DR. JESS AVERETTE POWELL III

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
222 N LAFAYETTE ST, SUITE 1, SHELBY, NC 28150-4444
(704) 482-3880
(704) 487-0294
Mailing address
222 N LAFAYETTE ST, SUITE 1, SHELBY, NC 28150-4444
(704) 482-3880
(704) 487-0294

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22163
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22163
NC MEDICAL LICENSE
NC
05
293590
SC
01
68644
NC BLUE CROSS BLUE SHIELD
NC
05
8968644
NC
Enumeration date
01/13/2006
Last updated
03/07/2023
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