Provider Demographics
NPI:1770739955
Name:CAROL M NEWLIN MD PHD PC
Entity type:Organization
Organization Name:CAROL M NEWLIN MD PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEWLIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MD
Authorized Official - Phone:970-224-3054
Mailing Address - Street 1:1236 E ELIZABETH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4000
Mailing Address - Country:US
Mailing Address - Phone:970-488-1668
Mailing Address - Fax:970-472-9381
Practice Address - Street 1:1305 ALFORD ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4217
Practice Address - Country:US
Practice Address - Phone:970-224-3054
Practice Address - Fax:970-493-2381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COD25033Medicare PIN
CO319114Medicare PIN