Provider Demographics
NPI:1700931912
Name:NEWTON, SARAH E (PAC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:E
Last Name:NEWTON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 1ST ST NE STE 1
Mailing Address - Street 2:
Mailing Address - City:WESSINGTON SPRINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57382
Mailing Address - Country:US
Mailing Address - Phone:605-539-9836
Mailing Address - Fax:605-539-1286
Practice Address - Street 1:300 S BYRON BLVD
Practice Address - Street 2:
Practice Address - City:CHAMBERLAIN
Practice Address - State:SD
Practice Address - Zip Code:57325-9741
Practice Address - Country:US
Practice Address - Phone:605-234-6551
Practice Address - Fax:605-234-7260
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0201363A00000X
FLPA9107319363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDS101452Medicare PIN
SDQ79320Medicare UPIN