Provider Demographics
NPI:1447784244
Name:NEWCOMER, JON WESLEY II (BS)
Entity Type:Individual
Prefix:MR
First Name:JON
Middle Name:WESLEY
Last Name:NEWCOMER
Suffix:II
Gender:M
Credentials:BS
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Mailing Address - Street 1:3284 NORTHSIDE PKWY NW
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2280
Mailing Address - Country:US
Mailing Address - Phone:866-782-1184
Mailing Address - Fax:877-241-5672
Practice Address - Street 1:3284 NORTHSIDE PKWY NW
Practice Address - Street 2:SUITE 600
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2280
Practice Address - Country:US
Practice Address - Phone:866-782-1184
Practice Address - Fax:877-241-5672
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
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Provider Licenses
StateLicense IDTaxonomies
GA052516617246ZE0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic