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SOUTHWELL AMBULATORY INC NPI 1962035360


NPI Information

NPI: 1962035360
Provider Name: SOUTHWELL AMBULATORY INC

Doing Business As: SOUTHWELL PEDIATRICS VALDOSTA

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
3014 N PATTERSON ST
VALDOSTA, GA
ZIP 31602
Phone: (229) 242-0194
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SOUTHWELL AMBULATORY INC is a pediatrics in Valdosta, GA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. SOUTHWELL AMBULATORY INC NPI is 1962035360. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southwell Pediatrics Valdosta.

The provider's business location address is:

3014 N PATTERSON ST
VALDOSTA, GA
ZIP 31602-711
Phone: (229) 242-0194
Fax: (229) 242-1785

The provider's authorized official is Troy Brooks .
The authorized official title is Svp/cfo and has the following contact phone number (229) 353-3397.

The enumeration date for this NPI number is 2/14/2020 and was last updated on 10/18/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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