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General NPI Number Information
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NPI Number | 1609856764
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Entity Type | Individual
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Provider Name | MATTHEW EARL NEWTON O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/17/2006
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Last Update Date | 07/13/2018
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Provider Practice Location Address
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Address Line | PSC 466
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City | FPO
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State | AP
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Zip | 96595
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Country | US
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Telephone | 0112463704200
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Fax | 0112463704217
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Provider Business Mailing Address
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Address Line | 137 SETON HILL RD
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-1579
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4220
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618000445
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License Number State | VA
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