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General NPI Number Information
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NPI Number | 1679680052
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Entity Type | Individual
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Provider Name | JACK RONALD NEWTON MD
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 05/05/2020
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Provider Practice Location Address
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Address Line | 2526 WESLEYAN PARK DR
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City | OWENSBORO
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State | KY
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Zip | 42301-5430
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Country | US
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Telephone | 270-929-6608
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Fax | 502-333-3131
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Provider Business Mailing Address
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Address Line | 8019 DIXIE HWY SUITE 101 JENCARE NEIGHBORHOOD MEDICAL VALLEY STATION, LLC
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City | LOUISVILLE
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State | KY
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Zip | 40258
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Country | US
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Telephone | 502-333-3121
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Fax | 502-333-3131
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 174400000X
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 18927
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18927
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License Number State | KY
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