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Individual

GEORGE A POWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
812 N JACKSON ST, HOUSTON, MS 38851-1203
(662) 456-2020
(662) 456-3494
Mailing address
PO BOX 717, HOUSTON, MS 38851-0717
(662) 456-2020
(662) 456-3494

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
580
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880035
MS
Enumeration date
12/21/2006
Last updated
03/03/2008
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