Healthcare Provider Details

I. General information

NPI: 1306059845
Provider Name (Legal Business Name): JAN BRISTOW NEWMAN MD, FACS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3436 MOUNTAIN DR
CLINTON MT
59825-9750
US

IV. Provider business mailing address

3436 MOUNTAIN DR
CLINTON MT
59825-9750
US

V. Phone/Fax

Practice location:
  • Phone: 406-258-6284
  • Fax:
Mailing address:
  • Phone: 406-258-6284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number6293
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number6293
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: