MEDICARE: THOMAS JOHN 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	207Q00000X	Family Medicine Physician	24499	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	105800	OTHER	U CARE
2	408092100	OTHER	MEDICAL ASSISTANCE
3	0126374	OTHER	MEDICA HEALTH PLANS
4	2114030	OTHER	FIRST HEALTH PLAN
5	86D74NE	OTHER	BLUE CROSS BLUE SHIELD
6	438505	OTHER	PREFERRED ONE
7	600948	OTHER	ARAZ GROUP AMERICAS PPO
8	HP22754	OTHER	HEALTH PARTNERS

General Provider Information

NPI Number	:	1750362794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS JOHN NEWTON MD

Provider Business Mailing Address
First Line	:	1360 ELM ST E
Second Line	:	CENTRACARE CLINIC ST JOSEPH FAMILY MEDICINE
City	:	SAINT JOSEPH
State	:	MN
Zip	:	56374-4694
Country	:	US
Telephone Number	:	320-363-7765
Fax Number	:	320-363-0031

Provider Business Practice Location Address
First Line	:	1360 ELM ST E
Second Line	:	CENTRACARE CLINIC ST JOSEPH FAMILY MEDICINE
City	:	SAINT JOSEPH
State	:	MN
Zip	:	56374-4694
Country	:	US
Telephone Number	:	320-363-7765
Fax Number	:	320-363-0031

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	06/29/2015

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