Provider Demographics
NPI:1780632695
Name:POWELL, JAMES O (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:O
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 1:840 MONTCLAIR RD
Mailing Address - Street 2:SUITE 722
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35213-1920
Mailing Address - Country:US
Mailing Address - Phone:205-591-2311
Mailing Address - Fax:205-592-3531
Practice Address - Street 1:840 MONTCLAIR RD
Practice Address - Street 2:SUITE 722
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35213-1920
Practice Address - Country:US
Practice Address - Phone:205-591-2311
Practice Address - Fax:205-592-3531
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4237173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000005113Medicare PIN
ALC75241Medicare UPIN
AL180007067Medicare PIN