Provider Demographics
NPI:1558362970
Name:WINKLER, GABOR A (MD)
Entity Type:Individual
Prefix:
First Name:GABOR
Middle Name:A
Last Name:WINKLER
Suffix:
Gender:M
Credentials:MD
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 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7042
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:1385 W BRIERBROOK RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2208
Practice Address - Country:US
Practice Address - Phone:901-390-2930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4184522086S0129X
TN693072086S0129X
SC364052086S0129X
NJMD418452208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC364055Medicaid
SC275350OtherMEDCOST
SC275350OtherMEDCOST