Provider Demographics
NPI:1396947214
Name:NEWLIN, ELMO MURRAY (DMD)
Entity type:Individual
Prefix:DR
First Name:ELMO
Middle Name:MURRAY
Last Name:NEWLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8019 ADELAIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-8029
Mailing Address - Country:US
Mailing Address - Phone:706-565-0249
Mailing Address - Fax:706-563-1189
Practice Address - Street 1:5815 MOON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3836
Practice Address - Country:US
Practice Address - Phone:706-563-6027
Practice Address - Fax:706-563-1189
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0087911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice