Provider Demographics
NPI:1962639732
Name:WINNER, JONATHAN (DO)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:WINNER
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 1:830 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-1657
Mailing Address - Country:US
Mailing Address - Phone:567-890-7138
Mailing Address - Fax:419-586-3045
Practice Address - Street 1:909 E WAYNE ST
Practice Address - Street 2:SUITE 124
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-3304
Practice Address - Country:US
Practice Address - Phone:419-586-1863
Practice Address - Fax:419-586-3045
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-010406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0060201Medicaid
OH0060201Medicaid