Organization
NEWPORT PEDIATRICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL MACK PUCKETT M.D. (PRESIDENT)
(423) 623-0653
Entity
Organization
Contact information
Practice address
1829 CROWE LN, NEWPORT, TN 37821-7264
(423) 623-0653
(423) 625-8264
Mailing address
1829 CROWE LN, NEWPORT, TN 37821-7264
(423) 623-0653
(423) 625-8264
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3710281
—
TN
Enumeration date
04/17/2007
Last updated
03/01/2025
Update your record
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