Healthcare Provider Details

I. General information

NPI: 1235271487
Provider Name (Legal Business Name): MARK W. NEWEY, DO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 4TH STREET
HEALDTON OK
73438
US

IV. Provider business mailing address

PO BOX 905
HEALDTON OK
73438-0905
US

V. Phone/Fax

Practice location:
  • Phone: 580-229-2333
  • Fax: 580-229-0924
Mailing address:
  • Phone: 580-229-2333
  • Fax: 580-229-0924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2185
License Number StateOK

VIII. Authorized Official

Name: MARK WAYNE NEWEY
Title or Position: OWNER
Credential: D.O.
Phone: 580-229-2333