Provider Demographics
NPI:1972500734
Name:WINDER, ERIC JAMES (DC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:JAMES
Last Name:WINDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 S TAMIAMI TRL
Mailing Address - Street 2:STE 102
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5101
Mailing Address - Country:US
Mailing Address - Phone:941-957-8390
Mailing Address - Fax:941-993-5860
Practice Address - Street 1:130 NEW CASTLE ST
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-1033
Practice Address - Country:US
Practice Address - Phone:724-738-9499
Practice Address - Fax:724-738-0488
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC006961L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA208503OtherUPMC
PAWI745060OtherHIGHMARK BLUE SHIELD
PAP00049262Medicare ID - Type UnspecifiedRAILROAD MEDICARE
PAU65394Medicare UPIN
PA745060QZZMedicare ID - Type Unspecified