MEDICARE: GREGORY S. NEWKIRK PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	1807	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	477802	OTHER	OH	OH MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093769515
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY S. NEWKIRK PA-C

Provider Business Mailing Address
First Line	:	6480 HARRISON AVE STE 201
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45247-7961
Country	:	US
Telephone Number	:	513-354-7785
Fax Number	:	513-354-7651

Provider Business Practice Location Address
First Line	:	500 E BUSINESS WAY STE A
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45241-2374
Country	:	US
Telephone Number	:	513-354-3700
Fax Number	:	513-354-3705

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	09/19/2020

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