Provider Demographics
NPI:1184625139
Name:WINDSOR, GEORGE EDWARD (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:EDWARD
Last Name:WINDSOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 107
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:MO
Mailing Address - Zip Code:65360
Mailing Address - Country:US
Mailing Address - Phone:660-647-2111
Mailing Address - Fax:660-647-2110
Practice Address - Street 1:114 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:MO
Practice Address - Zip Code:65360
Practice Address - Country:US
Practice Address - Phone:660-647-2111
Practice Address - Fax:660-647-2110
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO32300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO328280OtherFAMILY HEALTH PARTNERS
MO7449OtherHEALTH CARE USA
MO05245011OtherBCBS
MO0002047Medicare ID - Type Unspecified
MO7449OtherHEALTH CARE USA