OrganizationActive
Southwell Ambulatory Inc
NPI 1962035360 · Pediatrics Physician · Valdosta, GA
Provider details
- NPI number
- 1962035360
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Troy Brooks, Svp/Cfo(229) 353-3397
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3014 N Patterson St
Valdosta, GA 31602-1711
Phone: (229) 242-0194
Fax: (229) 242-1785
Street-level locationGet directions
Mailing address
907 18th St E Ste 400
Tifton, GA 31794-3684
Other names (DBA / former)
- Doing business as
- Southwell Pediatrics Valdosta
- Doing business as
- Southwell Pediatrics Valdosta
Registry dates
- Enumerated
- 2020-02-14
- Last updated
- 2022-10-18
- Certified
- 2022-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.