Individual
JAYSON POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCP
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(806) 236-2430
Mailing address
1131 KINGS PARK RD, MEMPHIS, TN 38117-5433
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
226
TN
Other
Enumeration date
05/08/2020
Last updated
05/08/2020
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