Healthcare Provider Details
I. General information
NPI: 1477991230
Provider Name (Legal Business Name): DAVID JOSEPH NEWTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/13/2013
Last Update Date: 10/04/2024
Certification Date: 10/04/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3871 E HIGHWAY 98 STE 203
PORT ST JOE FL
32456-5302
US
IV. Provider business mailing address
4205 BELFORT RD STE 4015
JACKSONVILLE FL
32216-3623
US
V. Phone/Fax
- Phone: 850-229-5661
- Fax: 850-229-5662
- Phone: 904-450-6063
- Fax: 904-539-4091
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | ME146368 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: