Provider Demographics
NPI:1124074281
Name:NEWCOMB, NORMAN R (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:R
Last Name:NEWCOMB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:N
Other - Middle Name:ROBERT
Other - Last Name:NEWCOMB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4005 W ROLLINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53545-8302
Mailing Address - Country:US
Mailing Address - Phone:608-295-1993
Mailing Address - Fax:
Practice Address - Street 1:4005 W ROLLINGWOOD DR
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53545-8302
Practice Address - Country:US
Practice Address - Phone:608-295-1993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI33901-020207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31886200Medicaid
WI3922OtherDEAN HEALTH INSURANCE
WI3922OtherDEAN HEALTH INSURANCE
WI001154340Medicare PIN
WI741501936Medicare PIN
WI290005320Medicare PIN