Healthcare Provider Details

I. General information

NPI: 1316172695
Provider Name (Legal Business Name): KRISTY L NEWTON, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2009
Last Update Date: 02/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7565 DANNAHER WAY
POWELL TN
37849-4029
US

IV. Provider business mailing address

7565 DANNAHER WAY
POWELL TN
37849-4029
US

V. Phone/Fax

Practice location:
  • Phone: 865-522-8821
  • Fax: 865-522-6650
Mailing address:
  • Phone: 865-522-8821
  • Fax: 865-522-6650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSANNE NELMS
Title or Position: PRACTICE ADMINISTRATOR/DIRECTOR
Credential:
Phone: 865-549-4892