Provider Demographics
NPI:1811326770
Name:WINKLES SURGICAL ASSISTING
Entity type:Organization
Organization Name:WINKLES SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED SURGICAL ASSISTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHALE
Authorized Official - Middle Name:
Authorized Official - Last Name:WINKLES
Authorized Official - Suffix:
Authorized Official - Credentials:CSFA
Authorized Official - Phone:678-848-4351
Mailing Address - Street 1:305 ROSE POINTE COURT
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005
Mailing Address - Country:US
Mailing Address - Phone:678-848-4351
Mailing Address - Fax:
Practice Address - Street 1:305 ROSE POINTE CT
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005-3648
Practice Address - Country:US
Practice Address - Phone:678-848-4351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2014-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA139732363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty