# SOUTHWELL AMBULATORY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Southwell OB/GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720693047
- **Authorized official:** TROY BROOKS (SVP/CFO)
- **Authorized official phone:** (229) 353-3397

## Contact information

- **Practice address:** 814 NORTHWOOD PARK DR, VALDOSTA, GA 31602-1398
- **Practice address phone:** (229) 262-6810
- **Practice address fax:** (229) 353-4901
- **Mailing address:** PO BOX 2650, TIFTON, GA 31793-2650
- **Mailing address phone:** (229) 402-0425
- **Mailing address fax:** (229) 391-4059

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/14/2020
- **Last updated:** 10/27/2025