Provider Demographics
NPI:1124097399
Name:NEWTON, GEORGE WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WILLIAM
Last Name:NEWTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-0886
Mailing Address - Country:US
Mailing Address - Phone:936-639-9609
Mailing Address - Fax:
Practice Address - Street 1:704 GASLIGHT BLVD
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3153
Practice Address - Country:US
Practice Address - Phone:936-632-2780
Practice Address - Fax:936-632-2781
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4170174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031249801Medicaid
TX0084BUOtherBCBS
TX0084BUOtherBCBS
TXF77217Medicare UPIN