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General NPI Number Information
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NPI Number | 1962639732
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Entity Type | Individual
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Provider Name | JONATHAN WINNER D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/18/2009
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Last Update Date | 02/21/2017
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Provider Practice Location Address
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Address Line | 909 E WAYNE ST SUITE 124
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City | CELINA
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State | OH
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Zip | 45822-3304
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Country | US
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Telephone | 419-586-1863
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Fax | 419-586-3045
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Provider Business Mailing Address
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Address Line | 830 W MAIN ST
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City | COLDWATER
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State | OH
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Zip | 45828-1657
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Country | US
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Telephone | 567-890-7138
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Fax | 419-586-3045
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34-010406
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License Number State | OH
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