Roy Powell Jr. (NPI# 1912905050, PAC ID# 1153398151) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.
| Nation Provider ID (NPI) | 1912905050 |
| PAC ID by PECOS | 1153398151 |
| Professional Enrollment ID | I20110303000947 |
| Full Name | Roy Powell Jr. |
| Organization Legal Name | RENAISSANCE PLASTIC SURGERY |
| Address |
4030 Riverside Park Blvd Macon GA 31210-1397 |
| Phone Number | 4784742200 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 1977 |
| Primary Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| Group Practice PAC ID | 7911994546 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110164 | COLISEUM MEDICAL CENTERS, LLC, DBA |
| Address | Phone | Organization |
|---|---|---|
| 4030 Riverside Park Blvd, Macon, GA 31210-1397 | 4784742200 | RENAISSANCE PLASTIC SURGERY |
| Organization Legal Name | RENAISSANCE PLASTIC SURGERY |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher L Mclendon | Plastic and Reconstructive Surgery | Renaissance Plastic Surgery | 4030 Riverside Park Blvd, Macon, GA 31210-1397 |
| Paul Syribeys | Plastic and Reconstructive Surgery | Renaissance Plastic Surgery | 4030 Riverside Park Blvd, Macon, GA 31210-1397 |
| Street Address |
4030 RIVERSIDE PARK BLVD |
| City | MACON |
| State | GA |
| Zip | 31210-1397 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher L Mclendon | Plastic and Reconstructive Surgery | Renaissance Plastic Surgery | 4030 Riverside Park Blvd, Macon, GA 31210-1397 |
| Paul Syribeys | Plastic and Reconstructive Surgery | Renaissance Plastic Surgery | 4030 Riverside Park Blvd, Macon, GA 31210-1397 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William S Hutchings | Family Medicine | Hutchings Health Care | 3096 Riverside Dr, Suite D, Macon, GA 31210-0420 |
| Dusty W Large | Chiropractic | 3040 Riverside Dr, Suite B3, Macon, GA 31210-0470 | |
| Billie L Jackson | Dermatology | 440 Charter Blvd, Ste. 2201, Macon, GA 31210-0706 | |
| Hyunji Choi | Dermatology | Dermatology Affiliates LLC | 440 Charter Blvd, Suite 2201, Macon, GA 31210-0706 |
| Valerie Jones-freeman | Internal Medicine | 420 Charter Blvd, Suite 306, Macon, GA 31210-0715 | |
| Joseph J Burnette | General Surgery | 420 Charter Blvd, Suite 302, Macon, GA 31210-0720 | |
| Laurie G Johnson | Nurse Practitioner | Peter O. Holliday IIi, Md, PC | 420 Charter Blvd, Suite 402, Macon, GA 31210-0722 |
| Pamela Onderko | Podiatry | 5223 Riverside Dr, Suite 104, Macon, GA 31210-0889 | |
| William J Woods | Internal Medicine | 220 N Macon St, Macon, GA 31210-1111 | |
| Torrence T Drakeford | Nurse Practitioner | Navicare LLC | 4795 Riverside Dr, Macon, GA 31210-1115 |
| Find all physicians in zip 31210 | |||
| City | MACON |
| Zip Code | 31210 |
| Specialty | PLASTIC AND RECONSTRUCTIVE SURGERY |
| City + Specialty | MACON + PLASTIC AND RECONSTRUCTIVE SURGERY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.