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Individual

DR. GEORGE EDMUND POWELL III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3226 HAMPTON AVE STE A, BRUNSWICK, GA 31520-4226
(912) 264-0760
(912) 264-5798
Mailing address
3226 HAMPTON AVE STE A, BRUNSWICK, GA 31520-4226
(912) 264-0760
(912) 264-5798

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
37046
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000360808G
GA
01
1821072398
NPI
01
37046
MEDICAL LICENSE
GA
01
926016
POCG
GA
05
REF000797672
GA
Enumeration date
11/30/2005
Last updated
03/07/2018
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