Healthcare Provider Details

I. General information

NPI: 1295720654
Provider Name (Legal Business Name): WINFIELD MEDICAL ARTS P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3625 QUAIL RIDGE RD
WINFIELD KS
67156-8881
US

IV. Provider business mailing address

3625 QUAIL RIDGE RD
WINFIELD KS
67156-8881
US

V. Phone/Fax

Practice location:
  • Phone: 620-221-6100
  • Fax: 620-221-7680
Mailing address:
  • Phone: 620-221-6100
  • Fax: 620-221-7680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KENT WINBLAD
Title or Position: CLINIC MANAGER
Credential: M.D.
Phone: 620-221-6100