Provider Demographics
NPI:1801972146
Name:NEWMAN, ALAN A (DC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:A
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1684 VENTURE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-8950
Mailing Address - Country:US
Mailing Address - Phone:740-392-7550
Mailing Address - Fax:740-392-5335
Practice Address - Street 1:1684 VENTURE DR
Practice Address - Street 2:SUITE F
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-8950
Practice Address - Country:US
Practice Address - Phone:740-392-7550
Practice Address - Fax:740-392-5335
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-30
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2226406Medicaid
V72105Medicare UPIN
OH2226406Medicaid