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NPI Code Detail

MEDICARE: DR. JASON M WINTERHALTER MD

MEDICARE: DR. JASON M WINTERHALTER 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
1207Q00000XFamily Medicine Physician34087075OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P000409024OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1639127756
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JASON M WINTERHALTER MD
Provider Business Mailing Address
First Line : 2000 NEWARK GRANVILLE RD
Second Line : SUITE 100
City : GRANVILLE
State : OH
Zip : 43023-9135
Country : US
Telephone Number : 740-587-0087
Fax Number : 740-587-0084
Provider Business Practice Location Address
First Line : 2000 NEWARK GRANVILLE RD
Second Line : SUITE 100
City : GRANVILLE
State : OH
Zip : 43023-9135
Country : US
Telephone Number : 740-587-0087
Fax Number : 740-587-0084
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2006
Last Update Date : 02/24/2016

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Directions to “ DR. JASON M WINTERHALTER MD” Practice Location

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