Provider Demographics
NPI:1376719237
Name:NEWKIRK, DONALD PAUL JR (OTR)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:PAUL
Last Name:NEWKIRK
Suffix:JR
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2003 PINEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-2078
Mailing Address - Country:US
Mailing Address - Phone:812-379-2902
Mailing Address - Fax:812-379-2901
Practice Address - Street 1:2003 PINEWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-2078
Practice Address - Country:US
Practice Address - Phone:812-379-2902
Practice Address - Fax:812-379-2901
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000249A174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist