Provider Demographics
NPI:1578522447
Name:LINDA CAROL NEWELL MD
Entity Type:Organization
Organization Name:LINDA CAROL NEWELL MD
Other - Org Name:NEWELL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:NEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-782-1050
Mailing Address - Street 1:6517 S KINGS RANCH RD
Mailing Address - Street 2:209
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85218-2903
Mailing Address - Country:US
Mailing Address - Phone:480-782-1050
Mailing Address - Fax:480-782-1052
Practice Address - Street 1:6499 S KINGS RANCH RD
Practice Address - Street 2:SUITE 13
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85218-2902
Practice Address - Country:US
Practice Address - Phone:480-775-4110
Practice Address - Fax:480-413-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ 23988261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ24311Medicare PIN
AZG79592Medicare UPIN