Individual
KEVIN R. GREENWELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
51 HOSPITAL RD, NEWNAN, GA 30263-1209
(770) 251-5540
Mailing address
51 HOSPITAL RD, NEWNAN, GA 30263-1209
(770) 251-5540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
024249
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00292234A
—
GA
Enumeration date
11/29/2005
Last updated
07/08/2007
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