Provider Demographics
NPI:1841761533
Name:SEWELL FAMILY MEDICINE AND URGENT CARE, P.C.
Entity Type:Organization
Organization Name:SEWELL FAMILY MEDICINE AND URGENT CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:KELE
Authorized Official - Last Name:SEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-796-0804
Mailing Address - Street 1:408 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3237
Mailing Address - Country:US
Mailing Address - Phone:678-796-0804
Mailing Address - Fax:678-796-0805
Practice Address - Street 1:408 MAPLE ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3237
Practice Address - Country:US
Practice Address - Phone:678-796-0804
Practice Address - Fax:678-796-0805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-06
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty