| Newsom Healthcare, Inc | |
| 
					2906 Goodman Rd W Suite 109 Horn Lake MS 38637-1291  | |
| (662) 393-8022 | |
| (662) 393-8052 | 
| Full Name | Newsom Healthcare, Inc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 2906 Goodman Rd W, Horn Lake, Mississippi | 
| Authorized Official Name and Position | Pam Alexander (ADMINISTRATOR) | 
| Authorized Official Contact | 9017565565 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Newsom Healthcare, Inc 3249 W Sarazens Cir Memphis TN 38125-0807 Ph: (901) 756-5565  | Newsom Healthcare, Inc 2906 Goodman Rd W Suite 109 Horn Lake MS 38637-1291 Ph: (662) 393-8022  | 
| NPI Number | 1972751154 | 
|---|---|
| Provider Enumeration Date | 08/30/2008 | 
| Last Update Date | 11/21/2012 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1972751154 | NPI | - | NPPES | 
| 07823202 | Medicaid | MS | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary | 
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