Provider Demographics
NPI:1205877537
Name:NEWMAN, JOSEPH RANDALL (MD)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:RANDALL
Last Name:NEWMAN
Suffix:
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 1:2000 PEPPERELL PKWY
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5452
Mailing Address - Country:US
Mailing Address - Phone:334-528-6655
Mailing Address - Fax:334-528-6657
Practice Address - Street 1:2000 PEPPERELL PKWY # 4
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5452
Practice Address - Country:US
Practice Address - Phone:334-528-6655
Practice Address - Fax:334-528-6657
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00014108207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL196642Medicaid
C73805Medicare UPIN
ALCM0081Medicare PIN
2910046OtherUNITED HEALTH CARE
C73805Medicare UPIN
AL0004232443OtherAETNA INSURANCE
630930725OtherCOMMERCIAL INSURANCE
C73805OtherHEALTHSPRINGS & SENIORS F
ALCM0081Medicare PIN
51089674OtherBLUE CROSS BLUE SHIELD AL
C73805OtherVIVA HEALTH