Provider Demographics
NPI:1417371642
Name:NEWBY, WILLIAM BRANDON (PA-C)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRANDON
Last Name:NEWBY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 80883
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30608-0883
Mailing Address - Country:US
Mailing Address - Phone:706-549-8114
Mailing Address - Fax:
Practice Address - Street 1:18 RIVERBEND DR SW
Practice Address - Street 2:SUITE 120
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-6013
Practice Address - Country:US
Practice Address - Phone:706-378-1202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical