MEDICARE: DR. CHARLES GORDON NEWTON JR. 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	24014	AL
2	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	ME111601	FL

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871586727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES GORDON NEWTON JR. M.D.

Provider Business Mailing Address
First Line	:	201 SIVLEY RD SW
Second Line	:	SUITE 300
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5134
Country	:	US
Telephone Number	:	256-533-1077
Fax Number	:	256-533-3379

Provider Business Practice Location Address
First Line	:	201 SIVLEY RD SW
Second Line	:	SUITE 300
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5134
Country	:	US
Telephone Number	:	256-533-1077
Fax Number	:	256-533-3379

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	08/19/2022

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Directions to “ DR. CHARLES GORDON NEWTON JR. M.D.” Practice Location

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