Organization
SOUTHWELL AMBULATORY INC
Active
Organization
SOUTHWELL AMBULATORY INC
Active
Other names
Southwell Infectious Disease
Organization subpart
No
Provider details
NPI number
Authorized official
TROY BROOKS (SVP/CFO)
(229) 353-3397
Entity
Organization
Contact information
Practice address
2301 N ASHLEY ST, VALDOSTA, GA 31602-2620
(229) 245-0666
Mailing address
907 18TH ST E STE 400, TIFTON, GA 31794-3684
(229) 353-3422
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
01/02/2020
Last updated
10/18/2022
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