MEDICARE: OLIVER THOMAS NEWCOMB III 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
1	208800000X	Urology Physician	24696	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1619901816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVER THOMAS NEWCOMB III M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1145
Second Line	:
City	:	MOREHEAD
State	:	KY
Zip	:	40351-5145
Country	:	US
Telephone Number	:	606-783-7689
Fax Number	:	606-784-5671

Provider Business Practice Location Address
First Line	:	245 FLEMINGSBURG RD
Second Line	:
City	:	MOREHEAD
State	:	KY
Zip	:	40351-1015
Country	:	US
Telephone Number	:	606-783-7689
Fax Number	:	606-784-5671

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	02/13/2023

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