Provider Demographics
NPI:1790268134
Name:WINTERS, RAE A (OD)
Entity type:Individual
Prefix:DR
First Name:RAE
Middle Name:A
Last Name:WINTERS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:13840 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9394
Mailing Address - Country:US
Mailing Address - Phone:317-720-2020
Mailing Address - Fax:317-458-1594
Practice Address - Street 1:13840 E 96TH ST
Practice Address - Street 2:
Practice Address - City:MCCORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46055-9394
Practice Address - Country:US
Practice Address - Phone:317-720-2020
Practice Address - Fax:317-458-1594
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN18004100A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist