Provider Demographics
NPI:1790006229
Name:WINCHESTER, SARA (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:WINCHESTER
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 1:100 S MARKET ST STE 2C
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67202-3824
Mailing Address - Country:US
Mailing Address - Phone:316-755-0144
Mailing Address - Fax:844-274-1204
Practice Address - Street 1:100 S MARKET ST STE 2C
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67202
Practice Address - Country:US
Practice Address - Phone:316-755-0144
Practice Address - Fax:844-274-1204
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS36013208M00000X
KS7448207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist