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General NPI Number Information
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NPI Number | 1356302137
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Entity Type | Individual
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Provider Name | J KARL WINCKELBACH D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 03/31/2006
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 33 E COUNTY LINE RD STE B
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City | GREENWOOD
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State | IN
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Zip | 46143-1043
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Country | US
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Telephone | 317-882-9303
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Fax | 317-882-6605
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Provider Business Mailing Address
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Address Line | 33 E COUNTY LINE RD STE B
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City | GREENWOOD
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State | IN
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Zip | 46143-1043
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Country | US
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Telephone | 317-882-9303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 07000316A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 07000316A
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License Number State | IN
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