Provider Demographics
NPI:1215065859
Name:NEWBY, FLOYD BRAD (DC)
Entity type:Individual
Prefix:DR
First Name:FLOYD
Middle Name:BRAD
Last Name:NEWBY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2161 SHERMAN RD
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-6820
Mailing Address - Country:US
Mailing Address - Phone:435-619-7366
Mailing Address - Fax:
Practice Address - Street 1:141 W BRIGHAM RD
Practice Address - Street 2:SUITE D
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7907
Practice Address - Country:US
Practice Address - Phone:435-619-7366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT292275-1202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
000057118Medicare ID - Type Unspecified