Provider Demographics
NPI:1811293871
Name:JEFFREY T NEWFIELD DO PA
Entity type:Organization
Organization Name:JEFFREY T NEWFIELD DO PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:NEWFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:386-672-8350
Mailing Address - Street 1:255 S YONGE ST
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-6258
Mailing Address - Country:US
Mailing Address - Phone:386-672-8350
Mailing Address - Fax:
Practice Address - Street 1:255 S YONGE ST
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-6258
Practice Address - Country:US
Practice Address - Phone:386-672-8350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0006365207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252148200Medicaid
FLF37556Medicare UPIN
FL80739Medicare PIN