Individual
SAMUEL L JEWETT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6000 JOE FRANK HARRIS PKWY NW, SUITE D, ADAIRSVILLE, GA 30103-2443
(770) 773-9201
(770) 773-3080
Mailing address
715 KNIGHT BOTTOM RD SE, FAIRMOUNT, GA 30139-2053
(770) 608-9379
(770) 773-3080
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002656
GA
Other
Enumeration date
05/22/2006
Last updated
07/08/2007
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