Provider Demographics
NPI:1134180243
Name:DILL, WINSTON E (JDPHDPSYDDNP)
Entity type:Individual
Prefix:DR
First Name:WINSTON
Middle Name:E
Last Name:DILL
Suffix:
Gender:M
Credentials:JDPHDPSYDDNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 ABERCORN ST
Mailing Address - Street 2:SUITE 705-322
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2447
Mailing Address - Country:US
Mailing Address - Phone:912-398-7311
Mailing Address - Fax:
Practice Address - Street 1:605 OSBORNE ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-8410
Practice Address - Country:US
Practice Address - Phone:912-398-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 2602363LP0808X
FL9206716363LA2200X
FLPY 6203103T00000X
IL071-005311103TC0700X
TNAPN 0000011387363LP0808X
GAPSY003277103TC0700X
GA196911NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist