Provider Demographics
NPI:1932260890
Name:MACK, NEWTON EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:NEWTON
Middle Name:EUGENE
Last Name:MACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W LEOTA ST STE 150
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-6579
Mailing Address - Country:US
Mailing Address - Phone:308-532-3022
Mailing Address - Fax:308-532-5831
Practice Address - Street 1:500 W LEOTA ST STE 150
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-6579
Practice Address - Country:US
Practice Address - Phone:308-532-3022
Practice Address - Fax:308-532-5831
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12510207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEB67656Medicare UPIN