Provider Demographics
NPI:1437161098
Name:NEWSOME, JILL MCDOWELL (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:MCDOWELL
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:ANNETTE
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:858 GARNERS LANDING BLVD
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-4132
Mailing Address - Country:US
Mailing Address - Phone:865-577-4311
Mailing Address - Fax:865-577-7942
Practice Address - Street 1:212 PHOENIX CT
Practice Address - Street 2:SUITE 1
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-3908
Practice Address - Country:US
Practice Address - Phone:865-577-6475
Practice Address - Fax:865-577-7942
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN028890208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4111397OtherBCBS-TN
TN3497524Medicaid
TNTN0101OtherJOHN DEERE HEALTH
G58443Medicare UPIN