Provider Demographics
NPI:1144331356
Name:WINFIELD FAMILY & OCCUPATIONAL MED PC
Entity type:Organization
Organization Name:WINFIELD FAMILY & OCCUPATIONAL MED PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-487-1586
Mailing Address - Street 1:191 CARRAWAY DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:WINFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35594
Mailing Address - Country:US
Mailing Address - Phone:205-487-1586
Mailing Address - Fax:205-487-1589
Practice Address - Street 1:191 CARRAWAY DR STE A
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:AL
Practice Address - Zip Code:35594-5074
Practice Address - Country:US
Practice Address - Phone:205-487-1586
Practice Address - Fax:205-487-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty