Provider Demographics
NPI:1417079666
Name:NEWTON, PYNKERTON DION (DC)
Entity Type:Individual
Prefix:DR
First Name:PYNKERTON
Middle Name:DION
Last Name:NEWTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2102 E 52ND ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-1496
Mailing Address - Country:US
Mailing Address - Phone:317-257-7463
Mailing Address - Fax:317-255-0758
Practice Address - Street 1:2102 E 52ND ST
Practice Address - Street 2:SUITE E
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-1496
Practice Address - Country:US
Practice Address - Phone:317-257-7463
Practice Address - Fax:317-255-0758
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001449111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200059030AMedicaid
IN200059030AMedicaid