Provider Demographics
NPI:1821229709
Name:WINBLAD, JAMES B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:WINBLAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 2019
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87499-2019
Mailing Address - Country:US
Mailing Address - Phone:505-325-1572
Mailing Address - Fax:505-327-4887
Practice Address - Street 1:801 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5630
Practice Address - Country:US
Practice Address - Phone:505-325-1572
Practice Address - Fax:505-327-4887
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO20160070472085R0202X, 2085R0204X
NMMD2020-02692085R0202X
ARE-97402085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology