Provider Demographics
NPI:1528164928
Name:NEWTON, CLYDE ALFRED (MD)
Entity type:Individual
Prefix:
First Name:CLYDE
Middle Name:ALFRED
Last Name:NEWTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19 BELMONT AVE
Mailing Address - Street 2:NO 101
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301
Mailing Address - Country:US
Mailing Address - Phone:802-257-0110
Mailing Address - Fax:802-257-0127
Practice Address - Street 1:19 BELMONT AVE
Practice Address - Street 2:NO 101
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301
Practice Address - Country:US
Practice Address - Phone:802-257-0110
Practice Address - Fax:802-257-0127
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420003916207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVT9682Medicare PIN
E41632Medicare UPIN