Provider Demographics
NPI:1962495333
Name:NEWELL, DONALD CLIFFORD JR (DO)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CLIFFORD
Last Name:NEWELL
Suffix:JR
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:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:LOCHGELLY
Mailing Address - State:WV
Mailing Address - Zip Code:25866-0130
Mailing Address - Country:US
Mailing Address - Phone:304-469-3334
Mailing Address - Fax:304-465-1735
Practice Address - Street 1:GENERAL DELIVERY
Practice Address - Street 2:
Practice Address - City:LOCHGELLY
Practice Address - State:WV
Practice Address - Zip Code:25866-0130
Practice Address - Country:US
Practice Address - Phone:304-469-3334
Practice Address - Fax:304-465-1735
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV542207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV221527OtherMAMSI & OPTIMUM CHOICE
WV4287095OtherAETNA PIN
WV743820OtherCARELINK COMMERCIAL
WV001714964OtherBCBS
WV2173175OtherUNITED HEALTHCARE-FFS
WV513906OtherRURAL HEALTH PROVIDER NO
WV080188849OtherRAILROAD MEDICARE
WVP00445655OtherRAILROAD MEDICARE
WV0049266000Medicaid
WV1962495333OtherBCBS
WV0049266000Medicaid
WVNE2029412Medicare PIN
WV2173175OtherUNITED HEALTHCARE-FFS
WVF34494Medicare UPIN