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Individual

DR. GARY R NEWSOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
701 UNIVERSITY BLVD E STE 204, TUSCALOOSA, AL 35401-7431
(205) 553-9171
(205) 553-9127
Mailing address
701 UNIVERSITY BLVD E STE 204, TUSCALOOSA, AL 35401-7431
(205) 553-9171
(205) 553-9127

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
21330
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51004718
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/17/2006
Last updated
11/05/2008
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