Provider Demographics
NPI:1003883588
Name:NEWTON, TARA (MD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6008 FOXBOROUGH SQ E
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5701
Mailing Address - Country:US
Mailing Address - Phone:615-598-0802
Mailing Address - Fax:615-622-8646
Practice Address - Street 1:404 N CASTLE HEIGHTS AVE STE F
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-1512
Practice Address - Country:US
Practice Address - Phone:615-784-4140
Practice Address - Fax:615-784-4139
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31311208000000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1503976Medicaid
TN1503976Medicaid