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General NPI Number Information
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NPI Number | 1740288430
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Entity Type | Individual
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Provider Name | JEFFREY WILLIAM SEWELL MD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 2131 S MOBBERLY AVE
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City | LONGVIEW
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State | TX
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Zip | 75602-3563
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Country | US
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Telephone | 903-758-2610
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Fax | 903-212-7689
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Provider Business Mailing Address
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Address Line | 1107 E MARSHALL AVE
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City | LONGVIEW
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State | TX
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Zip | 75601-5602
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Country | US
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Telephone | 903-758-2610
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Fax | 903-758-7081
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 37468
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD2007-0623
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | N7490
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License Number State | TX
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