Provider Demographics
NPI:1811073273
Name:NEWBORN REGIONAL PROVIDERS PLC
Entity type:Organization
Organization Name:NEWBORN REGIONAL PROVIDERS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:F
Authorized Official - Last Name:COLOSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:479-739-8043
Mailing Address - Street 1:PO BOX 11350
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72917-1350
Mailing Address - Country:US
Mailing Address - Phone:479-739-8043
Mailing Address - Fax:
Practice Address - Street 1:10608 INVERNESS ST
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72908-0703
Practice Address - Country:US
Practice Address - Phone:479-739-8043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-28
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty