Healthcare Provider Details

I. General information

NPI: 1760451371
Provider Name (Legal Business Name): JOHN A NEWCOMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 04/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 MEDICAL CENTER PT 260
COLORADO SPRINGS CO
80907-8731
US

IV. Provider business mailing address

2 S CASCADE AVE STE 140
COLORADO SPRINGS CO
80903-1624
US

V. Phone/Fax

Practice location:
  • Phone: 719-227-7800
  • Fax: 719-578-7755
Mailing address:
  • Phone: 719-538-2900
  • Fax: 719-538-2987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number27358
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number27358
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: