Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 17665 | MS |
Y | 207RI0011X | Interventional Cardiology | 17665 | MS |
NPI | 1083647879 |
---|---|
Provider Name | Dr. Michael D. Winniford |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 26/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0125909 | (05) | MS |
126125 | (05) | AL |
1461351 | (05) | LA |
A03205 | (02) | MS |
RR 060068580 | RAILROAD (01) | MS |