MEDICARE: ANTHONY CRAIG WINKLER IDC

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	1710I1002X	Independent Duty Corpsman

General Provider Information

NPI Number	:	1932433901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY CRAIG WINKLER IDC

Provider Business Mailing Address
First Line	:	USS DONALD COOK DDG 75
Second Line	:	MEDICAL DEPARTMENT
City	:	FPO
State	:	AE
Zip	:	09566-1294
Country	:	US
Telephone Number	:	757-444-8457
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS DONALD COOK DDG 75
Second Line	:	MEDICAL DEPARTMENT
City	:	FPO
State	:	AE
Zip	:	09566-1294
Country	:	US
Telephone Number	:	757-444-8457
Fax Number	:

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

Provider Enumeration Date	:	09/24/2009
Last Update Date	:	09/24/2009

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