=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427982545
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CURTIS WADE JEWELL
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2026
-----------------------------------------------------
Last Update Date | 06/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3460 BATTLEFIELD PKWY
-----------------------------------------------------
City | FORT OGLETHORPE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30742-4007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-406-5631
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6602 HARVESTVIEW LN
-----------------------------------------------------
City | HARRISON
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37341-5918
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-664-6084
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 17075
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------