| Clinton A. Winslow Md, Inc | |
|
4300 S Shields Blvd Oklahoma City OK 73129-2864 | |
| (405) 632-6681 | |
| (405) 632-6868 |
| Full Name | Clinton A. Winslow Md, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 4300 S Shields Blvd, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Clinton A Winslow (PRESIDENT) |
| Authorized Official Contact | 4056326681 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinton A. Winslow Md, Inc 1230 Westchester Dr Oklahoma City OK 73114-1215 Ph: (405) 810-9574 | Clinton A. Winslow Md, Inc 4300 S Shields Blvd Oklahoma City OK 73129-2864 Ph: (405) 632-6681 |
| NPI Number | 1063660561 |
|---|---|
| Provider Enumeration Date | 09/09/2008 |
| Last Update Date | 09/09/2008 |
| Medicare PECOS PAC ID | 4284793563 |
|---|---|
| Medicare Enrollment ID | O20081030000821 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063660561 | NPI | - | NPPES |
| 100253270B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14840 (Oklahoma) | Primary |
| Provider Name | Clinton A Winslow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205886744 PECOS PAC ID: 3274692553 Enrollment ID: I20081030000833 |
| Provider Name | Tammy L Wagstaff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780162560 PECOS PAC ID: 5597017798 Enrollment ID: I20181017001072 |
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