Provider Demographics
NPI:1427060318
Name:NEWCOMER, KELLEY FINCH (MD)
Entity type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:FINCH
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:LYNN
Other - Last Name:FINCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX BOAX # 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:214-645-8600
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-645-8600
Practice Address - Fax:214-645-0078
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2168207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00952LMedicare PIN
TXK2168OtherLICENSE