Provider Demographics
NPI:1023159324
Name:WINTER, CHRISTOPHER R (OD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:R
Last Name:WINTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:N63W23524 SILVER SPRING DR
Mailing Address - Street 2:PO BOX 144
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-0144
Mailing Address - Country:US
Mailing Address - Phone:262-246-8066
Mailing Address - Fax:
Practice Address - Street 1:N63W23524 SILVER SPRING DR
Practice Address - Street 2:BOX 144
Practice Address - City:SUSSEX
Practice Address - State:WI
Practice Address - Zip Code:53089-0144
Practice Address - Country:US
Practice Address - Phone:262-246-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1707152W00000X, 152WC0802X
CA9123152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIT63697Medicare UPIN