Provider Demographics
NPI:1851659593
Name:NEWBY, KATHRYN ANNE (DO)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ANNE
Last Name:NEWBY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KATHRYN
Other - Middle Name:ANNE
Other - Last Name:SHUNK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4848 E CACTUS RD
Mailing Address - Street 2:SUITE 620
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4163
Mailing Address - Country:US
Mailing Address - Phone:602-996-0190
Mailing Address - Fax:602-996-5516
Practice Address - Street 1:4848 E CACTUS RD
Practice Address - Street 2:SUITE 620
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4163
Practice Address - Country:US
Practice Address - Phone:602-996-0190
Practice Address - Fax:602-996-5516
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
IAR-9477208000000X
AZ006874208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program