Individual
KELLY EUGENE BEWSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 S 8TH ST STE 304, GRIFFIN, GA 30224-4260
(470) 267-2940
Mailing address
701 MCFARLAND ST, MORRISTOWN, TN 37814-3977
(423) 581-6084
(865) 374-2140
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
036116610
IL
208800000X
Urology Physician
58220
TN
208800000X
Urology Physician
Primary
98929
GA
208800000X
Urology Physician
MD424055
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116610
—
IL
05
—
100944016001
—
PA
05
—
Q045916
—
TN
Enumeration date
07/19/2005
Last updated
06/11/2025
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