Provider Demographics
NPI:1780213314
Name:NEWBERN, MOLLIE (DO)
Entity type:Individual
Prefix:
First Name:MOLLIE
Middle Name:
Last Name:NEWBERN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:501-955-2741
Mailing Address - Fax:501-955-4558
Practice Address - Street 1:3503 SOUTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-3897
Practice Address - Country:US
Practice Address - Phone:614-533-6140
Practice Address - Fax:614-533-6141
Is Sole Proprietor?:No
Enumeration Date:2020-04-06
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-19383207VX0201X
OH34.017349207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology