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General NPI Number Information
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NPI Number | 1164598421
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Entity Type | Organization
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Legal Business Name | SUNBURY CLINIC COMPANY, LLC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 337 ARCH ST
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City | SUNBURY
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State | PA
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Zip | 17801-2212
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Country | US
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Telephone | 570-286-0303
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Fax |
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Provider Business Mailing Address
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Address Line | 330 FRANKLIN RD #135A-333
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City | BRENTWOOD
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State | TN
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Zip | 37027-3280
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Country | US
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Telephone | 615-465-3152
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Fax | 615-465-3017
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Authorized Official
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Title or Position | PRESIDENT
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Name | GARY NEWSOME
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Credential |
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Telephone | 615-465-3152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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