# SOUTHWELL AMBULATORY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306466206
- **Authorized official:** TROY BROOKS (SVP/CFO)
- **Authorized official phone:** (229) 353-3397

## Contact information

- **Practice address:** 901 18TH ST E, TIFTON, GA 31794-3648
- **Practice address phone:** (229) 382-7120
- **Mailing address:** PO BOX 2650, TIFTON, GA 31793-2650
- **Mailing address phone:** (229) 353-3422
- **Mailing address fax:** (229) 391-4059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/21/2020
- **Last updated:** 10/27/2025