Provider Demographics
NPI:1861607632
Name:WINWARD, JOHN WILLIAM (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:WINWARD
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 1:1120 WELLINGTON AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6131
Mailing Address - Country:US
Mailing Address - Phone:970-243-7245
Mailing Address - Fax:
Practice Address - Street 1:1120 WELLINGTON AVE STE 206
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6131
Practice Address - Country:US
Practice Address - Phone:970-243-7245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO29117207L00000X
CODR.0055281207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR148063Medicare PIN