Provider Demographics
NPI:1184703498
Name:NEWTON, BRUCE COLE (CCP, LCP)
Entity type:Individual
Prefix:
First Name:BRUCE
Middle Name:COLE
Last Name:NEWTON
Suffix:
Gender:M
Credentials:CCP, LCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9615 SALEM TER
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:TN
Mailing Address - Zip Code:38002-9627
Mailing Address - Country:US
Mailing Address - Phone:901-829-4860
Mailing Address - Fax:901-829-5674
Practice Address - Street 1:9615 SALEM TER
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:TN
Practice Address - Zip Code:38002-9627
Practice Address - Country:US
Practice Address - Phone:901-829-4860
Practice Address - Fax:901-829-5674
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCP0000000030246X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246X00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist Cardiovascular