MEDICARE: DR. JAMES MICHAEL WINBERRY DC

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	225200000X	Physical Therapy Assistant	2812	AZ
2	111N00000X	Chiropractor	7217	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AZ0940580	OTHER	AZ	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1740276294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MICHAEL WINBERRY DC

Provider Business Mailing Address
First Line	:	2275 W MAGEE RD STE 112
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-4310
Country	:	US
Telephone Number	:	520-241-1995
Fax Number	:	520-300-7018

Provider Business Practice Location Address
First Line	:	2275 W MAGEE RD STE 112
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-4310
Country	:	US
Telephone Number	:	520-241-1995
Fax Number	:	520-300-7018

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

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	10/25/2017

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