Provider Demographics
NPI:1225389893
Name:E. THOMAS NEWBILL, MD, LLC
Entity Type:Organization
Organization Name:E. THOMAS NEWBILL, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:EMMA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-643-2287
Mailing Address - Street 1:12903 FOX MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-2270
Mailing Address - Country:US
Mailing Address - Phone:804-216-2187
Mailing Address - Fax:
Practice Address - Street 1:6900 FOREST AVE STE 115
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-1701
Practice Address - Country:US
Practice Address - Phone:804-893-8710
Practice Address - Fax:804-285-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101035155207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty