Provider Demographics
NPI:1760466874
Name:POWELL, FRANK S (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:S
Last Name:POWELL
Suffix:
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 1:775 POPLAR RD. STE 350
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-8304
Mailing Address - Country:US
Mailing Address - Phone:770-502-2150
Mailing Address - Fax:770-502-2103
Practice Address - Street 1:775 POPLAR RD STE 260
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-8303
Practice Address - Country:US
Practice Address - Phone:770-502-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-01
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA038914208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000020226GMedicaid
GA000020226GMedicaid
GAG21465Medicare UPIN