Individual
JARED THOMAS POWELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1378 UNION AVE, MEMPHIS, TN 38104-3623
(901) 725-3937
(901) 274-2342
Mailing address
1378 UNION AVE, MEMPHIS, TN 38104-3623
(901) 725-3937
(901) 274-2342
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1747
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1747
OD
TN
05
—
3940686
—
TN
Enumeration date
08/24/2005
Last updated
02/05/2024
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