Provider Demographics
NPI:1619029766
Name:WINCHESTER, CURTIS WAYNE (PA)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:WAYNE
Last Name:WINCHESTER
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1630 N KELLY PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5015
Mailing Address - Country:US
Mailing Address - Phone:520-722-0445
Mailing Address - Fax:
Practice Address - Street 1:1500 N WILMOT RD
Practice Address - Street 2:B-140
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4416
Practice Address - Country:US
Practice Address - Phone:520-296-6000
Practice Address - Fax:520-296-9864
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1430363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical