Provider Demographics
NPI:1316750177
Name:PEREZ, NEWTON ISAAC
Entity type:Individual
Prefix:
First Name:NEWTON
Middle Name:ISAAC
Last Name:PEREZ
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 1:202 WYBURN PL
Mailing Address - Street 2:
Mailing Address - City:BURNS
Mailing Address - State:TN
Mailing Address - Zip Code:37029-5110
Mailing Address - Country:US
Mailing Address - Phone:646-287-6246
Mailing Address - Fax:
Practice Address - Street 1:7207 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3916
Practice Address - Country:US
Practice Address - Phone:316-681-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program