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NPI Code Detail

MEDICARE: JOHN WINNINGHAM DO

MEDICARE: JOHN WINNINGHAM DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician6801OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20097MPOTHERTXBCBS

General Provider Information

NPI Number : 1174565279
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN WINNINGHAM DO
Provider Business Mailing Address
First Line : PO BOX 8549
Second Line :
City : FORT WORTH
State : TX
Zip : 76124-0549
Country : US
Telephone Number : 817-451-4208
Fax Number : 817-496-5151
Provider Business Practice Location Address
First Line : 4301 WILSON ST
Second Line :
City : LAWTON
State : OK
Zip : 73503-4472
Country : US
Telephone Number : 580-284-5566
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2006
Last Update Date : 02/21/2025

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