Provider Demographics
NPI:1962610030
Name:NEWTON, GREG (RPH)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:NEWTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 LEE ROAD 560
Mailing Address - Street 2:
Mailing Address - City:SMITHS STATION
Mailing Address - State:AL
Mailing Address - Zip Code:36877-2257
Mailing Address - Country:US
Mailing Address - Phone:706-887-0173
Mailing Address - Fax:
Practice Address - Street 1:5600 MILGEN RD STE 106
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-8701
Practice Address - Country:US
Practice Address - Phone:706-563-3016
Practice Address - Fax:706-565-7613
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15521183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist