Provider Demographics
NPI:1104235365
Name:NEWTON, JOHN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:NEWTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 BIG HORN AVE
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-9250
Mailing Address - Country:US
Mailing Address - Phone:307-250-9020
Mailing Address - Fax:
Practice Address - Street 1:3100 BIG HORN AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-9250
Practice Address - Country:US
Practice Address - Phone:307-250-9020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies