Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | OS 0007356 | FL |
NPI | 1346217635 |
---|---|
Provider Name | Kevin B Newfield |
First Address | Marathon, FL 33050-4016 |
Second Address | Marathon, FL 33050-4016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2006 |
Last Update Date | 06/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
253185200 | (05) | FL |
56765 | BLUE CROSS BLUE SHIELD (01) | FL |
G61115 | (02) | FL |