Healthcare Provider Details

I. General information

NPI: 1003883588
Provider Name (Legal Business Name): TARA NEWTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 N CASTLE HEIGHTS AVE STE F
LEBANON TN
37087-1512
US

IV. Provider business mailing address

6008 FOXBOROUGH SQ E
BRENTWOOD TN
37027-5701
US

V. Phone/Fax

Practice location:
  • Phone: 615-784-4140
  • Fax: 615-784-4139
Mailing address:
  • Phone: 615-598-0802
  • Fax: 615-622-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number31311
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number31311
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: