Individual
JOHN POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
101 MED TECH PKWY, SUITE 200, JOHNSON CITY, TN 37604-4007
(423) 232-6120
Mailing address
101 MED TECH PKWY, SUITE 200, JOHNSON CITY, TN 37604-4001
(423) 232-6120
(423) 232-6125
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000000508
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4101375
BLUE CROSS/BLUE SHIELD
TN
01
—
P00102484
MEDICARE RAILROAD
TN
01
—
TN0115
JOHN DEERE (JC)
TN
01
—
TN0116
JOHN DEERE (KPT)
TN
Enumeration date
06/29/2006
Last updated
08/29/2017
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