Provider Demographics
NPI:1053476010
Name:STEVEN PAUL WINKLER M D
Entity Type:Organization
Organization Name:STEVEN PAUL WINKLER M D
Other - Org Name:DESERT PREVENTATIVE AND DIAGNOSTIC MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WINKLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-617-8684
Mailing Address - Street 1:PO BOX 50823
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89016-0823
Mailing Address - Country:US
Mailing Address - Phone:702-617-8684
Mailing Address - Fax:702-617-2560
Practice Address - Street 1:10001 S EASTERN AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3907
Practice Address - Country:US
Practice Address - Phone:702-617-8684
Practice Address - Fax:702-617-2560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7842207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019984Medicaid
NVG32285Medicare UPIN