Provider Demographics
NPI:1225042377
Name:NEWMAN, ADAM G (MD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:G
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 E 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-4704
Mailing Address - Country:US
Mailing Address - Phone:870-425-6398
Mailing Address - Fax:879-425-6402
Practice Address - Street 1:130 E 9TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-4704
Practice Address - Country:US
Practice Address - Phone:870-425-6398
Practice Address - Fax:879-425-6402
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040334062086S0122X
ARE58102086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO# PENDINGMedicaid
MO961153230Medicare PIN
MO# PENDINGMedicaid
MO961153268Medicare PIN