Healthcare Provider Details

I. General information

NPI: 1861422180
Provider Name (Legal Business Name): TIMOTHY WAYNE WINKLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 UNIVERSITY BLVD EAST
TUSCALOOSA AL
35401-2029
US

IV. Provider business mailing address

1820 RICE MINE ROAD NORTH SUITE 200
TUSCALOOSA AL
35406-3282
US

V. Phone/Fax

Practice location:
  • Phone: 205-333-4655
  • Fax: 205-333-4660
Mailing address:
  • Phone: 205-333-4655
  • Fax: 205-333-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number17857
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: