Provider Demographics
NPI:1366467425
Name:WINN, WILLIAM RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:RICHARD
Last Name:WINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 7177
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7177
Mailing Address - Country:US
Mailing Address - Phone:559-217-9403
Mailing Address - Fax:559-636-6395
Practice Address - Street 1:400 W MINERAL KING
Practice Address - Street 2:KAWEAH DELTA MEDICAL CTR
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291
Practice Address - Country:US
Practice Address - Phone:559-642-2000
Practice Address - Fax:559-735-3058
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2016-11-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG 8235207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000G82350Medicaid
CA77-0460556OtherTAX ID
CA000G82350Medicaid
CA000G82350Medicaid