Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 11968 | MS |
N | 207XS0117X | Orthopaedic Spine Surgeon | 11968 | MS |
NPI | 1093733172 |
---|---|
Provider Name | Charles Joseph Winters |
First Address | Vancleave, MS 39565-6771 |
Second Address | Vancleave, MS 39565-6771 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00117284 | (05) | MS |
B65326 | (02) |