Provider Demographics
NPI:1740276294
Name:WINBERRY, JAMES MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MICHAEL
Last Name:WINBERRY
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 1:2275 W MAGEE RD STE 112
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-4310
Mailing Address - Country:US
Mailing Address - Phone:520-241-1995
Mailing Address - Fax:520-300-7018
Practice Address - Street 1:2275 W MAGEE RD STE 112
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-4310
Practice Address - Country:US
Practice Address - Phone:520-241-1995
Practice Address - Fax:520-300-7018
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2812225200000X
AZ7217111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0940580OtherBLUE CROSS BLUE SHIELD