Provider Demographics
NPI:1497884993
Name:NEW, HAROLD DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:DOUGLAS
Last Name:NEW
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:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37662-0009
Mailing Address - Country:US
Mailing Address - Phone:423-857-2066
Mailing Address - Fax:423-857-2070
Practice Address - Street 1:617 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210-9700
Practice Address - Country:US
Practice Address - Phone:276-676-3870
Practice Address - Fax:276-628-8927
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257093207N00000X
KY43422207N00000X
TN49741207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00847185OtherRR MEDICARE
VAP01582842OtherRAILROAD MEDICARE
VAP01554204OtherRR MEDICARE
9492505OtherAETNA
KY7100121390Medicaid
P400017053Medicare PIN
VAP01582842OtherRAILROAD MEDICARE