Healthcare Provider Details

I. General information

NPI: 1073516423
Provider Name (Legal Business Name): CATHERINE L SEWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 03/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4040 DUTCHMANS LN STE A
LOUISVILLE KY
40207-4712
US

IV. Provider business mailing address

1602 HATCHER LN
COLUMBIA TN
38401-4827
US

V. Phone/Fax

Practice location:
  • Phone: 931-388-0777
  • Fax: 931-388-1548
Mailing address:
  • Phone: 931-388-0777
  • Fax: 931-388-1548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number25270
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number0
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: