# SOUTHWELL AMBULATORY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southwell Gastroenterology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164069472
- **Authorized official:** TROY BROOKS (SVP/CFO)
- **Authorized official phone:** (229) 353-3397

## Contact information

- **Practice address:** 2922 N OAK ST STE C, VALDOSTA, GA 31602-1885
- **Practice address phone:** (229) 244-1570
- **Practice address fax:** (229) 299-4291
- **Mailing address:** PO BOX 2650, TIFTON, GA 31793-2650
- **Mailing address phone:** (229) 353-3422
- **Mailing address fax:** (229) 353-6060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2019
- **Last updated:** 10/27/2025