Provider Demographics
NPI:1558518357
Name:JOHN N WINNIE MD; PC
Entity Type:Organization
Organization Name:JOHN N WINNIE MD; PC
Other - Org Name:FOLKSTON FAMILY PRACTICE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:WINNIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:912-496-4839
Mailing Address - Street 1:4402 SECOND STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:FOLKSTON
Mailing Address - State:GA
Mailing Address - Zip Code:31537-3124
Mailing Address - Country:US
Mailing Address - Phone:912-496-4839
Mailing Address - Fax:
Practice Address - Street 1:4402 SECOND STREET
Practice Address - Street 2:SUITE B
Practice Address - City:FOLKSTON
Practice Address - State:GA
Practice Address - Zip Code:31537-3124
Practice Address - Country:US
Practice Address - Phone:912-496-4839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033757261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000469785DMedicaid