Provider Demographics
NPI:1689644569
Name:NEWTH, MARK S (DO)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:NEWTH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 SW 6TH AVE
Mailing Address - Street 2:STE 320
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1011
Mailing Address - Country:US
Mailing Address - Phone:785-232-4248
Mailing Address - Fax:785-232-0945
Practice Address - Street 1:6001 SW 6TH AVE
Practice Address - Street 2:STE 320
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1011
Practice Address - Country:US
Practice Address - Phone:785-232-4248
Practice Address - Fax:785-232-0945
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0518524207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS106748OtherBLUE CROSS BLUE SHIELD
KS106748Medicare PIN
KS106748OtherBLUE CROSS BLUE SHIELD
P00438465Medicare PIN