Individual
DR. PATRICK ELLISON SEWELL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1421 E PEACE ST, A, CANTON, MS 39046-4938
(601) 832-2643
Mailing address
1421 E PEACE ST, A, CANTON, MS 39046-4938
(601) 832-2643
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
14876
MS
2085N0700X
Neuroradiology Physician
14876
MS
2085N0904X
Nuclear Radiology Physician
14876
MS
2085P0229X
Pediatric Radiology Physician
14876
MS
2085R0001X
Radiation Oncology Physician
14876
MS
2085R0202X
Diagnostic Radiology Physician
14876
MS
2085R0203X
Therapeutic Radiology Physician
14876
MS
2085R0204X
Vascular & Interventional Radiology Physician
Primary
14876
MS
2085U0001X
Diagnostic Ultrasound Physician
14876
MS
Other
Enumeration date
08/31/2006
Last updated
11/02/2007
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