Provider Demographics
NPI:1033393806
Name:NEWBOLD, SCOTT GILBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:GILBERT
Last Name:NEWBOLD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 27128
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84127-0128
Mailing Address - Country:US
Mailing Address - Phone:435-868-5500
Mailing Address - Fax:435-868-5538
Practice Address - Street 1:1303 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-9746
Practice Address - Country:US
Practice Address - Phone:435-868-5500
Practice Address - Fax:435-868-5538
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
UT6951975-1201208000000X
MT12609208000000X
CA20A9913208000000X
UT6951975-1204208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics