Healthcare Provider Details

I. General information

NPI: 1144213950
Provider Name (Legal Business Name): GARY JAY NEWMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2005
Last Update Date: 01/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14239 W BELL RD STE. 201
SURPRISE AZ
85374-2469
US

IV. Provider business mailing address

PO BOX 53568
PHOENIX AZ
85072-3568
US

V. Phone/Fax

Practice location:
  • Phone: 623-584-0800
  • Fax: 623-584-0312
Mailing address:
  • Phone: 623-544-5075
  • Fax: 623-544-5093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number3131
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: