Provider Demographics
NPI:1639189780
Name:SEWELL, FRANK K JR (MD)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:K
Last Name:SEWELL
Suffix:JR
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:PO BOX 381
Mailing Address - Street 2:HENDERSON
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42419-0381
Mailing Address - Country:US
Mailing Address - Phone:270-298-4889
Mailing Address - Fax:
Practice Address - Street 1:1305 NORTH ELM ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-0048
Practice Address - Country:US
Practice Address - Phone:270-631-2399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY16490208600000X
IN01052529A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000200967OtherANTHEM
IN200270030AMedicaid
IN000000200967OtherANTHEM
KY64164908Medicaid
IN180030Medicare ID - Type Unspecified
C65404Medicare UPIN
IN200270030AMedicaid