Provider Demographics
NPI:1326349267
Name:NEWSOME, DANIEL COLBY (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:COLBY
Last Name:NEWSOME
Suffix:
Gender:M
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3170 MAPLELEAF DR
Mailing Address - Street 2:APARTMENT 1504
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2612
Mailing Address - Country:US
Mailing Address - Phone:606-205-9897
Mailing Address - Fax:
Practice Address - Street 1:3205 SUMMIT SQUARE
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509
Practice Address - Country:US
Practice Address - Phone:859-335-9041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KYTC036363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant