Individual
MACY POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1220 BASTOGNE DR, MARYVILLE, TN 37801
(865) 414-2878
Mailing address
1220 BASTOGNE DR, MARYVILLE, TN 37801-9304
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/03/2026
Last updated
02/03/2026
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