Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 18140 | MS |
N | 111NI0900X | Internist | 18140 | MS |
N | 207RC0000X | Internist - Cardiovascular Disease | 18140 | MS |
Y | 207RI0011X | Interventional Cardiology | 18140 | MS |
NPI | 1124113667 |
---|---|
Provider Name | Dr. John Gorham Winscott JR. |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 26/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07407323 | (05) | MS |
P01212520 | RAILROAD MEDICARE (01) | MS |