Provider Demographics
NPI:1447898127
Name:NEWLAND, DONALD KEITH (LDO)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:KEITH
Last Name:NEWLAND
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8107 LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3817
Mailing Address - Country:US
Mailing Address - Phone:502-905-4113
Mailing Address - Fax:
Practice Address - Street 1:8107 LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3817
Practice Address - Country:US
Practice Address - Phone:502-905-4113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY111736156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty