Provider Demographics
NPI:1326079583
Name:WINFREE, KERSEY L (MD)
Entity Type:Individual
Prefix:
First Name:KERSEY
Middle Name:L
Last Name:WINFREE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 268986
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8986
Mailing Address - Country:US
Mailing Address - Phone:405-231-3857
Mailing Address - Fax:405-272-7977
Practice Address - Street 1:100 W MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-9024
Practice Address - Country:US
Practice Address - Phone:405-815-5060
Practice Address - Fax:405-815-5065
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2020-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK15752207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD95614Medicare UPIN