Provider Demographics
NPI:1760447346
Name:WINT, JEFFREY C (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:C
Last Name:WINT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 MAIN STREET
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1086
Mailing Address - Country:US
Mailing Address - Phone:413-733-2204
Mailing Address - Fax:413-734-0587
Practice Address - Street 1:3550 MAIN STREET
Practice Address - Street 2:SUITE 204
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1086
Practice Address - Country:US
Practice Address - Phone:413-733-2204
Practice Address - Fax:413-734-0587
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA76399207XS0106X
CT035130207XS0106X
NJ25MA05133400207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
171167OtherHARVARD PILGRIM
17791OtherHNE
6180058002OtherCIGNA
MAJ12523OtherBCBS PPO
J12523OtherBCBS OUT OF STATE
484126OtherCONNECTICARE
76399OtherTUFTS
MAJ12523OtherBCBS HMO
17791OtherHNE
000000020830Medicare ID - Type UnspecifiedPROV NUMBER
484126OtherCONNECTICARE
J12523Medicare ID - Type Unspecified