Healthcare Provider Details

I. General information

NPI: 1093325458
Provider Name (Legal Business Name): NEWTON MEDICAL & TELEHEALTH CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 08/04/2020
Certification Date: 08/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 SCHOOL STREET EXT
NEWTON MS
39345-2272
US

IV. Provider business mailing address

PO BOX 3189
MERIDIAN MS
39303-3189
US

V. Phone/Fax

Practice location:
  • Phone: 601-678-6713
  • Fax: 601-483-5569
Mailing address:
  • Phone: 601-917-0810
  • Fax: 601-483-5569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. RAZEE AMEIR AHMAD
Title or Position: OWNER
Credential: MD
Phone: 601-917-0810