Individual
DAMON NEWSOME JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
940 PARKWAY DR, SALYERSVILLE, KY 41465-9251
(606) 298-3412
(606) 298-5123
Mailing address
1709 KY ROUTE 321, PRESTONSBURG, KY 41653-9097
(606) 886-8546
(606) 886-8548
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
024870
NY
363AM0700X
Medical Physician Assistant
24870
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000524189
BCBS
KY
01
—
000559736001
BCBS HIGHMARK
NY
05
—
07268739
—
NY
05
—
95004933
—
KY
01
—
P00176973
RAILROAD
—
01
—
Q00328306
RAILROAD
NY
Enumeration date
01/10/2006
Last updated
09/18/2024
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