Provider Demographics
NPI:1477569531
Name:WINKLMANN, JOHN J (PA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:J
Last Name:WINKLMANN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:HEALY
Mailing Address - State:AK
Mailing Address - Zip Code:99743-0062
Mailing Address - Country:US
Mailing Address - Phone:907-683-2305
Mailing Address - Fax:907-683-2306
Practice Address - Street 1:MILEPOST 238.8 PARKS HWY
Practice Address - Street 2:
Practice Address - City:DENALI PARK
Practice Address - State:AK
Practice Address - Zip Code:99755-9999
Practice Address - Country:US
Practice Address - Phone:907-683-4433
Practice Address - Fax:907-683-4434
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK20363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S18975Medicare UPIN