Provider Demographics
NPI:1790424489
Name:UNITY HEALTH - NEWPORT
Entity Type:Organization
Organization Name:UNITY HEALTH - NEWPORT
Other - Org Name:UNITY HEALTH NEWPORT PODIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:POOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-278-8346
Mailing Address - Street 1:1117 MCLAIN ST STE 500
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72112-3546
Mailing Address - Country:US
Mailing Address - Phone:870-523-9100
Mailing Address - Fax:870-523-9107
Practice Address - Street 1:1117 MCLAIN ST STE 500
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-3546
Practice Address - Country:US
Practice Address - Phone:870-523-9100
Practice Address - Fax:870-523-9107
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITY HEALTH - NEWPORT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-01
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty