MEDICARE: JAMES BRYON NEWTON P.A.-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	363AM0700X	Medical Physician Assistant	5601002361	MI

General Provider Information

NPI Number	:	1811085475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BRYON NEWTON P.A.-C.

Provider Business Mailing Address
First Line	:	4249 PINE KNOLL AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49004-9506
Country	:	US
Telephone Number	:	269-491-0947
Fax Number	:

Provider Business Practice Location Address
First Line	:	4249 PINE KNOLL AVE
Second Line	:
City	:	KALAMAZOO
State	:	MI
Zip	:	49004-9506
Country	:	US
Telephone Number	:	269-491-0947
Fax Number	:

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	09/09/2015

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