Provider Demographics
NPI:1689794653
Name:WINICK, KATHRYN ANNETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ANNETTE
Last Name:WINICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9031 SW 29TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73179-2818
Mailing Address - Country:US
Mailing Address - Phone:405-512-6950
Mailing Address - Fax:
Practice Address - Street 1:9031 SW 29TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73179-2818
Practice Address - Country:US
Practice Address - Phone:405-512-6950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP8326207ZP0105X
FLME117824207ZP0105X
390200000X
OK27901207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program