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NPI Code Detail

MEDICARE: DR. JENNIFER DALE NEWTON M.D.

MEDICARE: DR. JENNIFER DALE NEWTON M.D.
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
1207V00000XObstetrics & Gynecology PhysicianN8550TX

General Provider Information

NPI Number : 1578769659
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER DALE NEWTON M.D.
Provider Business Mailing Address
First Line : 2017 RICKETY LN
Second Line :
City : TYLER
State : TX
Zip : 75703-1706
Country : US
Telephone Number : 903-533-8811
Fax Number : 903-593-5511
Provider Business Practice Location Address
First Line : 2017 RICKETY LN
Second Line :
City : TYLER
State : TX
Zip : 75703-1706
Country : US
Telephone Number : 903-533-8811
Fax Number : 903-593-5511
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2007
Last Update Date : 12/04/2013

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