Provider Demographics
NPI:1740204999
Name:NEWTON, ALBERT HOMER III (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:HOMER
Last Name:NEWTON
Suffix:III
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 1:2900 DOCTORS PARK DR
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8127
Mailing Address - Country:US
Mailing Address - Phone:541-282-2200
Mailing Address - Fax:541-282-2237
Practice Address - Street 1:2900 DOCTORS PARK DR
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-8127
Practice Address - Country:US
Practice Address - Phone:541-282-2200
Practice Address - Fax:541-282-2237
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD20571207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR150456Medicaid
ORE80913Medicare UPIN
OR150456Medicaid