Individual
DR. SCOTTY RAY NEWCOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
210 E GRAY ST STE 604, LOUISVILLE, KY 40202-3902
(502) 629-5633
(502) 629-5580
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5395
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
TP624
KY
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
04347
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/08/2015
Last updated
04/13/2021
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