Provider Demographics
NPI:1548258122
Name:WINFIELD, GENE M (DO)
Entity type:Individual
Prefix:
First Name:GENE
Middle Name:M
Last Name:WINFIELD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2307 S RURAL RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2424
Mailing Address - Country:US
Mailing Address - Phone:480-557-0051
Mailing Address - Fax:480-557-0189
Practice Address - Street 1:2307 S RURAL RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2424
Practice Address - Country:US
Practice Address - Phone:480-557-0051
Practice Address - Fax:480-557-0189
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ809668Medicaid
AZ2Z0233OtherHEALTH NET
AZ2284447OtherUNITED HEALTHCARE
AZAZ0747750OtherBCBS
AZ265238OtherGREAT WEST
AZ2923190OtherCIGNA
AZ3144497OtherAETNA
AZ809668Medicaid
AZH90797Medicare UPIN