Dick J Newell, D.O.

Individual provider Active NPI Family Medicine Physician · Bloomfield, MO

NPI 1558395103 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1558395103
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
R7434 (MO)
Practice address
101 S. Prairie
Bloomfield, MO 63825
Phone
(573) 568-3838
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R7434MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R7434 MO Yes

Addresses

Primary practice location

101 S. Prairie
Bloomfield, MO 63825

Mailing address

2620 N Westwood Blvd
Poplar Bluff, MO 63901-3396
Phone (573) 727-2772

Other providers in Bloomfield, MO

All providers in Bloomfield, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.