Provider Demographics
NPI:1417937871
Name:POWELL, JAMES BLACKMON II (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BLACKMON
Last Name:POWELL
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WALDEN RIDGE
Mailing Address - Street 2:STE 200
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8591
Mailing Address - Country:US
Mailing Address - Phone:828-654-9299
Mailing Address - Fax:828-654-9266
Practice Address - Street 1:7 WALDEN RIDGE
Practice Address - Street 2:STE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8591
Practice Address - Country:US
Practice Address - Phone:828-654-9299
Practice Address - Fax:828-654-9266
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18822207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC68767Medicaid
NCC86046Medicare ID - Type Unspecified
NC68767Medicaid