Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 08400 | MS |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 12898 | AL |
NPI | 1043257793 |
---|---|
Provider Name | Dr. Barry Douglas Newsom |
First Address | Tuscaloosa, AL 35406-1662 |
Second Address | Tuscaloosa, AL 35401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 02/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
051539107 | (05) | AL |
07851373 | MEDICAID OF MS (01) | MS |
515-39107 | BCBS OF AL (01) | AL |
C76386 | (02) | AL |
P00378526 | RAILROAD MEDICARE PIN (01) |