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General NPI Number Information
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NPI Number | 1215092804
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Entity Type | Organization
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Legal Business Name | DAVID W WINELAND
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 1180 N COURT ST SUITE F
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-1397
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Country | US
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Telephone | 740-477-2504
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Fax | 740-477-1987
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Provider Business Mailing Address
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Address Line | 1180 N COURT ST SUITE F
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City | CIRCLEVILLE
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State | OH
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Zip | 43113-1397
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Country | US
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Telephone | 740-477-2504
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Fax | 740-477-1987
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Authorized Official
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Title or Position | SOLE OWNER OF GROUP PRACTICE
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Name | DR. DAVID WILLIAM WINELAND
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Credential | O.D.
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Telephone | 740-477-2504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3755T701
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License Number State | OH
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