Individual
DR. ROY POWELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4030 RIVERSIDE PARK BLVD, MACON, GA 31210-1365
(478) 474-2200
(478) 314-0740
Mailing address
4030 RIVERSIDE PARK BLVD, MACON, GA 31210-1365
(478) 474-2200
(478) 314-0740
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
19981
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00306545A
—
GA
Enumeration date
07/12/2005
Last updated
07/08/2007
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