1962495333 NPI number — DR. DONALD CLIFFORD NEWELL JR. D.O.

Table of content: DR. FRANCK-LUCIE CASTHELY DMD, MPH, MS (NPI 1144650342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962495333 NPI number — DR. DONALD CLIFFORD NEWELL JR. D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NEWELL
Provider First Name:
DONALD
Provider Middle Name:
CLIFFORD
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
D.O.
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:
1962495333
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 130
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOCHGELLY
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
25866-0130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-469-3334
Provider Business Mailing Address Fax Number:
304-465-1735

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GENERAL DELIVERY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOCHGELLY
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
25866-0130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-469-3334
Provider Business Practice Location Address Fax Number:
304-465-1735
Provider Enumeration Date:
08/31/2005

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: 207Q00000X , with the licence number:  542 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 221527 . This is a "MAMSI & OPTIMUM CHOICE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 4287095 . This is a "AETNA PIN" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 743820 . This is a "CARELINK COMMERCIAL" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 001714964 . This is a "BCBS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 2173175 . This is a "UNITED HEALTHCARE-FFS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 513906 . This is a "RURAL HEALTH PROVIDER NO" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 080188849 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: P00445655 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".
  • Identifier: 0049266000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1962495333 . This is a "BCBS" identifier , issued by the state of ( WV ) . This identifiers is of the category "OTHER".




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