Individual
BRADLY C. NEWCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
510 RUBY DR, MADISONVILLE, KY 42431-2168
(270) 399-7900
(270) 399-7910
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
39210
KY
208VP0000X
Pain Medicine Physician
Primary
39210
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000362048
BCBS PROVIDER NUMBER
—
01
—
39210
LICENSE
KY
05
—
64098379
—
KY
Enumeration date
09/17/2006
Last updated
05/03/2019
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