Provider Demographics
NPI:1710942891
Name:WINTERS, CHAD (DO)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:
Last Name:WINTERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23351 PRAIRIE STAR PKWY STE A245
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66227-7301
Mailing Address - Country:US
Mailing Address - Phone:913-676-8630
Mailing Address - Fax:913-676-8635
Practice Address - Street 1:23351 PRAIRIE STAR PKWY STE A245
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66227-7301
Practice Address - Country:US
Practice Address - Phone:913-676-8630
Practice Address - Fax:913-676-8635
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS33455207Q00000X
MO2002012703207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine