Provider Demographics
NPI:1225227499
Name:WOLINSKY, JOEL S (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:S
Last Name:WOLINSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 62428
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33906-2428
Mailing Address - Country:US
Mailing Address - Phone:281-265-1776
Mailing Address - Fax:239-215-0065
Practice Address - Street 1:108 JOSHUA RD
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76087-6036
Practice Address - Country:US
Practice Address - Phone:281-265-1776
Practice Address - Fax:239-215-0065
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-23
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031554174400000X
TXK11352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00753QOtherMEDICARE
TX045431603Medicaid
TX045431603Medicaid