Provider Demographics
NPI:1235102591
Name:WINTERS, JENNIFER B (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:B
Last Name:WINTERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 EATON AVE
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-4603
Mailing Address - Country:US
Mailing Address - Phone:513-892-9222
Mailing Address - Fax:513-892-9009
Practice Address - Street 1:855 EATON AVE
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-4603
Practice Address - Country:US
Practice Address - Phone:513-892-9222
Practice Address - Fax:513-892-9009
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007615W207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2451083Medicaid
OH2451083Medicaid