Provider Demographics
NPI:1649258559
Name:WINKLER, SCOTT R (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:R
Last Name:WINKLER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 VINE ST
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:KY
Mailing Address - Zip Code:42071-2630
Mailing Address - Country:US
Mailing Address - Phone:270-753-6477
Mailing Address - Fax:270-753-6478
Practice Address - Street 1:732 VINE ST
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071-2630
Practice Address - Country:US
Practice Address - Phone:270-753-6477
Practice Address - Fax:270-753-6478
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY001536174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYKY001536OtherKY PT LICENSE
KY000000049118OtherANTHEM
KY87000360Medicaid
KY163649600OtherDEPARTMENT OF LABOR
KYC10478OtherRAILROAD MEDICARE
KY6400179OtherUNITED HEALTHCARE
KY6400179OtherUNITED HEALTHCARE
KY87000360Medicaid