Organization
FJP MEDICAL
Active
Other names
Powell Total Medical and Serenity
Organization subpart
No
Provider details
NPI number
Authorized official
FRED JOE POWELL MD (OWNER)
(912) 729-7246
Entity
Organization
Contact information
Practice address
140 THE LAKES BLVD STE C, KINGSLAND, GA 31548-6814
(912) 729-7246
(912) 729-2929
Mailing address
140 THE LAKES BLVD STE C, KINGSLAND, GA 31548-6814
(912) 729-7246
(912) 729-2929
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
65488
GA
261QP3300X
Pain Clinic/Center
Primary
65488
GA
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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