Provider Demographics
NPI:1164495966
Name:WINKOSKI, JEFFREY D (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:WINKOSKI
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:N17 W24100 RIVERWOOD DRIVE SUITE 250
Mailing Address - Street 2:PROHEALTH CARE MEDICAL ASSOCIATES INC.
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-1177
Mailing Address - Country:US
Mailing Address - Phone:262-928-4100
Mailing Address - Fax:262-928-5835
Practice Address - Street 1:PROHEALTH CARE MEDICAL CENTERS-NEW BERLIN
Practice Address - Street 2:13900 W NATIONAL AVENUE
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151
Practice Address - Country:US
Practice Address - Phone:262-928-4500
Practice Address - Fax:292-928-4550
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2011-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI36115207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32084700Medicaid
WIF70907Medicare UPIN
WI683750687Medicare PIN