Provider Demographics
NPI:1316943673
Name:WINTON, MARK D (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:D
Last Name:WINTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MARK
Other - Middle Name:D
Other - Last Name:WINTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:905 HIGHLAND BLVD
Mailing Address - Street 2:SUITE 4500
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6901
Mailing Address - Country:US
Mailing Address - Phone:406-414-4210
Mailing Address - Fax:
Practice Address - Street 1:905 HIGHLAND BLVD
Practice Address - Street 2:SUITE 4500
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715
Practice Address - Country:US
Practice Address - Phone:406-414-5200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36530207RI0200X
MT11649207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO127617OtherGROUP HEALTH PLANS
MO24081OtherBLUE CROSS BLUE SHIELD
MO202030003OtherMISSOURI CARE
MO2443OtherHEALTHCARE USA
MO9204000OtherUNITED HEALTHCARE
MO470872293OtherTRICARE
MSA10703OtherMERCY
MO440003884OtherRAILROAD MEDICARE
MO202030003Medicaid
MO176373OtherHEALTHLINK
MO202030003OtherMISSOURI CARE
MO470872293OtherTRICARE