Provider Demographics
NPI:1154398071
Name:WINN, TERRIA L (MD)
Entity type:Individual
Prefix:
First Name:TERRIA
Middle Name:L
Last Name:WINN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1851 N WEBB RD
Mailing Address - Street 2:ATTN FLR2
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3413
Mailing Address - Country:US
Mailing Address - Phone:316-636-2010
Mailing Address - Fax:316-858-3830
Practice Address - Street 1:834 N SOCORA ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67212-3279
Practice Address - Country:US
Practice Address - Phone:316-722-8883
Practice Address - Fax:316-721-4864
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2008-02-26
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Provider Licenses
StateLicense IDTaxonomies
KS0420382207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSB69155Medicare UPIN
KS040554Medicare PIN