Healthcare Provider Details
I. General information
NPI: 1487091112
Provider Name (Legal Business Name): ANDREW NEWTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/04/2013
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
IV. Provider business mailing address
1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US
V. Phone/Fax
- Phone: 504-842-4070
- Fax: 504-842-3124
- Phone: 504-842-4000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | S6904 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 333032 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: