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NPI Code Detail

MEDICARE: JON R WINTER DO

MEDICARE: JON R WINTER 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 Physician824TN

General Provider Information

NPI Number : 1932134871
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON R WINTER DO
Provider Business Mailing Address
First Line : 145 HOSPITAL DR
Second Line :
City : CAMDEN
State : TN
Zip : 38320-1617
Country : US
Telephone Number : 731-584-3141
Fax Number : 731-584-3143
Provider Business Practice Location Address
First Line : 145 HOSPITAL DR
Second Line :
City : CAMDEN
State : TN
Zip : 38320-1617
Country : US
Telephone Number : 731-584-3141
Fax Number : 731-584-3143
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 11/04/2009

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