1932293479 NPI number — DR. BARRETT W NEWSOME DO

Table of content: LESLY PENATE (NPI 1013651157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932293479 NPI number — DR. BARRETT W NEWSOME DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWSOME
Provider First Name:
BARRETT
Provider Middle Name:
W
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932293479
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 LOCUST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTHAMPTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01060-2052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-582-2900
Provider Business Mailing Address Fax Number:
413-582-2905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 LOCUST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-2052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-582-2900
Provider Business Practice Location Address Fax Number:
413-582-2905
Provider Enumeration Date:
10/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  RT 1426 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: DO1991 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 257406 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)