Provider Demographics
NPI:1740666205
Name:GEORGE A WINCH JR MD PC
Entity type:Organization
Organization Name:GEORGE A WINCH JR MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-738-7877
Mailing Address - Street 1:PO BOX 2724
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89803-2724
Mailing Address - Country:US
Mailing Address - Phone:775-738-7877
Mailing Address - Fax:775-738-9542
Practice Address - Street 1:1780 BROWNING WAY STE C
Practice Address - Street 2:
Practice Address - City:ELKO
Practice Address - State:NV
Practice Address - Zip Code:89801-8357
Practice Address - Country:US
Practice Address - Phone:775-738-7877
Practice Address - Fax:775-738-9542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-07
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V108095Medicare PIN