Provider Demographics
NPI: | 1821271867 |
---|---|
Name: | BARON NEWTON MD LLC |
Entity Type: | Organization |
Organization Name: | BARON NEWTON MD LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | BARON |
Authorized Official - Middle Name: | B |
Authorized Official - Last Name: | NEWTON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 337-436-5233 |
Mailing Address - Street 1: | 1920 W SALE RD |
Mailing Address - Street 2: | STE 7 |
Mailing Address - City: | LAKE CHARLES |
Mailing Address - State: | LA |
Mailing Address - Zip Code: | 70605-2400 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 337-436-5233 |
Mailing Address - Fax: | 337-436-5234 |
Practice Address - Street 1: | 1920 W SALE RD |
Practice Address - Street 2: | STE 7 |
Practice Address - City: | LAKE CHARLES |
Practice Address - State: | LA |
Practice Address - Zip Code: | 70605-2400 |
Practice Address - Country: | US |
Practice Address - Phone: | 337-436-5233 |
Practice Address - Fax: | 337-436-5234 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2007-12-13 |
Last Update Date: | 2012-09-05 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
LA | 06323R | 208600000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty |