Provider Demographics
NPI:1598221483
Name:NEWTON, KEITH
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:NEWTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 YORK ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:AR
Mailing Address - Zip Code:71671-3218
Mailing Address - Country:US
Mailing Address - Phone:870-226-9970
Mailing Address - Fax:
Practice Address - Street 1:412 YORK ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:AR
Practice Address - Zip Code:71671-3218
Practice Address - Country:US
Practice Address - Phone:870-226-9970
Practice Address - Fax:870-226-9972
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator