Healthcare Provider Details

I. General information

NPI: 1639189780
Provider Name (Legal Business Name): FRANK K SEWELL JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 NORTH ELM ST
HENDERSON KY
42420-0048
US

IV. Provider business mailing address

PO BOX 381 HENDERSON
HENDERSON KY
42419-0381
US

V. Phone/Fax

Practice location:
  • Phone: 270-631-2399
  • Fax:
Mailing address:
  • Phone: 270-298-4889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number16490
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01052529A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: