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NPI Code Detail

MEDICARE: JEFFREY K WINGATE MD

MEDICARE: JEFFREY K WINGATE MD
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
1207XS0117XOrthopaedic Surgery of the Spine Physician036128599IL
2207XS0117XOrthopaedic Surgery of the Spine Physician04-42522KS
3207XS0117XOrthopaedic Surgery of the Spine Physician4301088960MI

General Provider Information

NPI Number : 1235117524
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY K WINGATE MD
Provider Business Mailing Address
First Line : 1221 BOWERS ST UNIT 2710
Second Line :
City : BIRMINGHAM
State : MI
Zip : 48012-7106
Country : US
Telephone Number : 248-228-0054
Fax Number : 248-566-3316
Provider Business Practice Location Address
First Line : 21230 DEQUINDRE RD
Second Line :
City : WARREN
State : MI
Zip : 48091-2279
Country : US
Telephone Number : 248-228-0054
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 06/06/2025

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