Individual
KENNETH A POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 JONES STREET, APPOMATTOX, VA 24522
(434) 352-8235
(434) 352-5532
Mailing address
103 JONES STREET, APPOMATTOX, VA 24522
(434) 352-8235
(434) 352-5532
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101026525
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5608813
—
VA
Enumeration date
11/25/2005
Last updated
07/08/2007
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