Provider Demographics
NPI:1497751804
Name:SMITH, NEWTON BIRRELL (MD)
Entity Type:Individual
Prefix:DR
First Name:NEWTON
Middle Name:BIRRELL
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 POSADA LN
Mailing Address - Street 2:STE 201
Mailing Address - City:TEMPLETON
Mailing Address - State:CA
Mailing Address - Zip Code:93465-4060
Mailing Address - Country:US
Mailing Address - Phone:805-434-0876
Mailing Address - Fax:805-434-0386
Practice Address - Street 1:350 POSADA LN
Practice Address - Street 2:STE 201
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4060
Practice Address - Country:US
Practice Address - Phone:805-434-0876
Practice Address - Fax:805-434-0386
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53926207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF51937Medicare UPIN
CAGG078ZMedicare UPIN