MEDICARE: DR. BRUCE Y NEWTON MD

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	208100000X	Physical Medicine & Rehabilitation Physician	2630961205	UT

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	:	1679565170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE Y NEWTON MD

Provider Business Mailing Address
First Line	:	280 S MAIN ST
Second Line	:
City	:	BOUNTIFUL
State	:	UT
Zip	:	84010-6236
Country	:	US
Telephone Number	:	801-262-8486
Fax Number	:

Provider Business Practice Location Address
First Line	:	1160 E 3900 S STE 4050
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84124-1264
Country	:	US
Telephone Number	:	801-262-8486
Fax Number	:	801-284-8699

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

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	08/24/2023

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