Provider Demographics
NPI:1982776068
Name:WINDER, JAMES W (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:WINDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 ELM ST STE 306
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4540
Mailing Address - Country:US
Mailing Address - Phone:775-470-8030
Mailing Address - Fax:775-470-8033
Practice Address - Street 1:343 ELM ST STE 306
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4540
Practice Address - Country:US
Practice Address - Phone:775-470-8030
Practice Address - Fax:775-470-8033
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54499208000000X
NV5315208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV20-16509Medicaid
NVF66716Medicare UPIN