Healthcare Provider Details

I. General information

NPI: 1013176379
Provider Name (Legal Business Name): NEWTON HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 06/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5126 HOSPITAL DR NE
COVINGTON GA
30014-2566
US

IV. Provider business mailing address

5126 HOSPITAL DR NE
COVINGTON GA
30014-2566
US

V. Phone/Fax

Practice location:
  • Phone: 770-385-7053
  • Fax:
Mailing address:
  • Phone: 770-385-7053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number059146
License Number StateGA

VIII. Authorized Official

Name: MR. TROY B BROOKS
Title or Position: CFO
Credential:
Phone: 770-385-4426