MEDICARE: NEWSOM HEALTHCARE, INC

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

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	:	1972751154
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEWSOM HEALTHCARE, INC

Provider Business Mailing Address
First Line	:	3249 W SARAZENS CIR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38125-0807
Country	:	US
Telephone Number	:	901-756-5565
Fax Number	:	901-756-5564

Provider Business Practice Location Address
First Line	:	2906 GOODMAN RD W
Second Line	:	SUITE 109
City	:	HORN LAKE
State	:	MS
Zip	:	38637-1291
Country	:	US
Telephone Number	:	662-393-8022
Fax Number	:	662-393-8052

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. PAM ALEXANDER
Credential	:
Telephone Number	:	901-756-5565

Provider Enumeration Date	:	08/30/2008
Last Update Date	:	11/21/2012

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Directions to “NEWSOM HEALTHCARE, INC ” Practice Location

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