Provider Demographics
NPI:1962818146
Name:THE NEWBORN ASSOCIATES, PA
Entity Type:Organization
Organization Name:THE NEWBORN ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:WENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-957-7345
Mailing Address - Street 1:PO BOX 24356
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39225-4356
Mailing Address - Country:US
Mailing Address - Phone:601-957-7345
Mailing Address - Fax:769-251-5429
Practice Address - Street 1:5001 MARDY ST.
Practice Address - Street 2:WESLEY MEDICAL CENTER
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402
Practice Address - Country:US
Practice Address - Phone:601-268-8155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE NEWBORN ASSOCIATES, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical CareGroup - Single Specialty