1235126459 NPI number — DR. JOSEPH T NEWMAN D.P.M.

Table of content: DR. JOSEPH T NEWMAN D.P.M. (NPI 1235126459)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235126459 NPI number — DR. JOSEPH T NEWMAN D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWMAN
Provider First Name:
JOSEPH
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
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:
1235126459
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/15/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2600 UNIVERSITY AVE
Provider Second Line Business Mailing Address:
STE 206
Provider Business Mailing Address City Name:
WEST DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50266-1462
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-223-6214
Provider Business Mailing Address Fax Number:
515-440-3776

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2700 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
WEST DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50266-1451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-223-6214
Provider Business Practice Location Address Fax Number:
515-440-3776
Provider Enumeration Date:
10/03/2005

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: 213E00000X , with the licence number:  532 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 42147412001 . This is a "JOHN DEERE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 1235126459 . This is a "CIGNA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 2081513 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 480025628 . This is a "BCBS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 8081 . This is a "MIDLAND'S CHOICE" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com