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General NPI Number Information
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NPI Number | 1629490628
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Entity Type | Organization
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Legal Business Name | JOHN W. NEWLIN, M.D., LLC
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Dates
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Enumeration Date | 01/09/2014
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Last Update Date | 01/09/2014
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Provider Practice Location Address
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Address Line | 302 W HAY ST SUITE 130
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City | DECATUR
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State | IL
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Zip | 62526-4167
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Country | US
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Telephone | 217-872-8100
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Fax | 217-872-8101
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Provider Business Mailing Address
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Address Line | 302 W HAY ST SUITE 130
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City | DECATUR
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State | IL
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Zip | 62526-4167
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Country | US
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Telephone | 217-872-8100
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Fax | 217-872-8101
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | JOHN WESLEY NEWLIN
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Credential | M.D.
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Telephone | 217-872-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036074839
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License Number State | IL
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