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General NPI Number Information
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NPI Number | 1831198118
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Entity Type | Individual
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Provider Name | KELLY EUGENE BEWSEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 619 S 8TH ST STE 304
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City | GRIFFIN
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State | GA
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Zip | 30224-4260
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Country | US
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Telephone | 470-267-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 701 MCFARLAND ST
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City | MORRISTOWN
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State | TN
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Zip | 37814-3977
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Country | US
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Telephone | 423-581-6084
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Fax | 865-374-2140
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD424055
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036116610
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 58220
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 98929
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License Number State | GA
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