1083665061 NPI number — DR. CHARLES F WINKLER MD

Table of content: DR. CHARLES F WINKLER MD (NPI 1083665061)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083665061 NPI number — DR. CHARLES F WINKLER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINKLER
Provider First Name:
CHARLES
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1083665061
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 7564
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PADUCAH
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42002-7564
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-554-0011
Provider Business Mailing Address Fax Number:
270-554-6540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 KIANA CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PADUCAH
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42001-6787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-554-0011
Provider Business Practice Location Address Fax Number:
270-554-6540
Provider Enumeration Date:
05/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X , with the licence number:  MD0000020188 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 17391 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000329300 . This is a "ANTHEM BCBS OF KY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 0910601 . This is a "UMWA" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: C70713 . This is a "BLUEGRASS FAMILY HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 069193 . This is a "HEALTH ALLIANCE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 4079538 . This is a "BCBS OF TN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 64173917 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3048083 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5007956 . This is a "TLC-FAMILYCAREHLTHPLAN" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 000000236012 . This is a "UNISON HEALTH MEDICARE ADVANTAGE" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: 020248399 . This is a "DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 179570 . This is a "HEALTH LINK" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 2968 . This is a "CHA HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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