Provider Demographics
NPI:1275614711
Name:ATWELL, GEORGE W (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:ATWELL
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 1:204 W BRAINERD ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-3058
Mailing Address - Country:US
Mailing Address - Phone:850-434-5043
Mailing Address - Fax:
Practice Address - Street 1:204 W BRAINERD ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3058
Practice Address - Country:US
Practice Address - Phone:850-434-5043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA201061208D00000X
FLME35727207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice