DR. JACK BITTELL SEWELL (NPI# 1326032665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326032665 |
| Entity Type | Individual |
| Full Name | DR. JACK BITTELL SEWELL |
| Credential | M.D. |
| Practice Address |
901 E Sunflower Rd Cleveland MS 38732-2833 |
| Mailing Address |
Po Box 468 Berwick PA 18603-0468 |
| Practice Telephone | 6628460061 |
| Mailing Telephone | 6109560003 |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2011-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
05320 | MS | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME22971 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBS | 58248 | 01 |
| FL | TAX ID | 134262411 | 01 |
| FL | MEDICARE RR | P00041336 | 01 |
| Street Address |
901 E SUNFLOWER RD |
| City | CLEVELAND |
| State | MS |
| Zip Code | 38732-2833 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356733265 | G & G Health Services, LLC | Specialist | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2015-03-02 |
| 1962822692 | Catherine Tanner Petzinger | Surgery | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2014-04-21 |
| 1306142062 | Phc-cleveland Inc | Psychiatric Unit | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2011-01-28 |
| 1770889461 | Phc-cleveland Inc | Medicare Defined Swing Bed Unit | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2011-01-28 |
| 1194048231 | Delta Radiology Pllc | Radiology | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2010-03-03 |
| 1952537938 | Nouveau Anesthesia Medical Group | Anesthesiology | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2009-06-04 |
| 1396996997 | Acs Emergency Services of Mississippi Professional Association | Physician Assistant | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2008-10-02 |
| 1891968327 | Edward Kofi Lartevi Md Pmc | Emergency Medicine | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2008-04-04 |
| 1306916937 | Bolivar Pathology Services | Clinical Medical Laboratory | 901 E Sunflower Rd, 901 Hwy 8 East, Cleveland, MS 38732-2833 | 2006-11-09 |
| 1528158532 | Phc-cleveland Inc | Radiology | 901 E Sunflower Rd, Cleveland, MS 38732-2833 | 2006-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023629219 | Marilynn Pruitt | Technician | 108 Belvedere Court, Cleveland, MS 38732 | 2020-08-12 |
| 1417322587 | United Family Life Center | Clinic/Center | 1101 S Martin Luther King Drive, Cleveland, MS 38732 | 2015-12-01 |
| 1346661584 | Rebecca Winters | Speech-Language Pathologist | 4036 Hwy 8 East, Cleveland, MS 38732 | 2013-12-13 |
| 1982973186 | Delta Home Health Inc | Home Health | 300-b South Street, Cleveland, MS 38732 | 2011-12-19 |
| 1730467382 | Reid Farmer Davis Medico | Clinic/Center | 4080 Highway 8 West, Cleveland, MS 38732 | 2011-08-01 |
| 1700181427 | Sondra Speakes Huerta | Speech-Language Pathologist | 3939 Hwy 61 N. Suite 110, Cleveland, MS 38732 | 2011-01-12 |
| 1386956027 | Delta Soul Medical, LLC | Hospice Care, Community Based | 102 N. Pearman Ave., Ste. 1, Cleveland, MS 38732 | 2010-07-10 |
| 1700029675 | Jlrl, LLC | Dentist | 716 First Street, Cleveland, MS 38732 | 2009-04-08 |
| 1417194978 | Bolivar Emergency Group LLC | Physician Assistant | 901 Hwy 8 East Sunflower Rd, Cleveland, MS 38732 | 2009-01-20 |
| 1902055767 | Word of Deliverance Adult Day Care | Custodial Care Facility | 509 Davis Avenue, Cleveland, MS 38732 | 2008-09-16 |
| Find all providers in zip 38732 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568845279 | Rod Momenian | Radiology | 9500 Euclid Ave # Oh44195, Cleveland, OH 44195-1716 | 2015-06-30 |
| 1508123985 | Allan Chiunda | Radiology | Cleveland Clinic Foundation Diagnostic 9500 Ave, Cleveland, OH 44195-0001 | 2012-04-23 |
| 1659652915 | Fatemeh Abdollahi Mofakham | Radiology | 9500 Euclid Ave # A21, Cleveland, OH 44195-0006 | 2011-08-31 |
| 1306008743 | Leah Kim Sieck | Radiology | Crile Building Desk A 10, 9500 Euclid Avenue, Cleveland, OH 44195-0001 | 2008-06-26 |
| 1962669754 | Aqeel Ahmad Chowdhry | Radiology | 1445 E 105th St, Cleveland, OH 44106-1137 | 2008-05-20 |
| 1912174954 | Laura Hagen Dean | Radiology | 9500 Euclid Ave # A10, Cleveland, OH 44195-0001 | 2008-05-09 |
| 1164610671 | Claus Simpfendorfer | Radiology | 9500 Euclid Ave - Desk A21, Cleveland, OH 44195 | 2007-10-10 |
| 1427257716 | Daniel Michael Roesel | Radiology | 9500 Euclid Ave # Hb6, Cleveland, OH 44195-5114 | 2007-07-16 |
| 1124222872 | Christopher Coppa | Radiology | 9500 Euclid Avenue, Hb6, Cleveland Clinic Foundation, Cleveland, OH 44195 | 2007-06-14 |
| 1891900114 | Rosalinn Santa Cruz | Radiology | 25001 Emery Rd Ste 100, Cleveland, OH 44128-5627 | 2007-05-11 |
| Find all providers in CLEVELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.