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Individual

JOHN STANLEY NEWSOME

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OPTICIAN

Taxonomy

Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
703
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20278
PARTNERS
NC
01
77115
BCBS
NC
01
78269
MEDCOST
NC
05
8801912
NC
Enumeration date
11/30/2005
Last updated
08/20/2010
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