MEDICARE: DR. JERROLD A WINTER 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
1	207RC0000X	Cardiovascular Disease Physician	9892	AZ
2	207RC0001X	Clinical Cardiac Electrophysiology Physician	9892	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1962480137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERROLD A WINTER MD

Provider Business Mailing Address
First Line	:	3709 N CAMPBELL AVE STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1563
Country	:	US
Telephone Number	:	520-838-3148
Fax Number	:	520-838-2260

Provider Business Practice Location Address
First Line	:	2404 E RIVER RD
Second Line	:	BLD 2 STE100
City	:	TUCSON
State	:	AZ
Zip	:	85718-6520
Country	:	US
Telephone Number	:	520-696-4780
Fax Number	:	520-293-7024

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	02/01/2018

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