Provider Demographics
NPI:1922780501
Name:SEWELL, JULIA (OD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SEWELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 E MCDOWELL RD STE 301
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2609
Mailing Address - Country:US
Mailing Address - Phone:602-222-2234
Mailing Address - Fax:
Practice Address - Street 1:1010 E MCDOWELL RD STE 301
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2609
Practice Address - Country:US
Practice Address - Phone:602-222-2234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOPT-002724152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist