MEDICARE: MR. WILLIAM DAVID WINKLES B.S.

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
1	183500000X	Pharmacist	4436	TN

General Provider Information

NPI Number	:	1700975075
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM DAVID WINKLES B.S.

Provider Business Mailing Address
First Line	:	7917 LONG DR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-2726
Country	:	US
Telephone Number	:	423-899-1259
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 CUMBERLAND ST STE 110
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37404-1918
Country	:	US
Telephone Number	:	423-495-9203
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	07/08/2007

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