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Organization

SEWANEE FAMILY PRACTICE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LOUIS E KOELLA MD (PRESIEDENT)
(931) 598-5648
Entity
Organization

Contact information

Practice address
1314 UNIVERSITY AVE, SEWANEE, TN 37375-2336
(931) 598-5648
(931) 598-0778
Mailing address
PO BOX 700, SEWANEE, TN 37375-0700
(931) 598-5648
(931) 598-0778

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1376
TN
207Q00000X
Family Medicine Physician
Primary
34975
TN
207Q00000X
Family Medicine Physician
713
TN

Other

Enumeration date
10/24/2014
Last updated
10/24/2014
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