Provider Demographics
NPI:1386693976
Name:WINTER, LANCE (DO)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:WINTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:LANCE
Other - Middle Name:
Other - Last Name:WINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20401 N 73RD ST STE 140
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4148
Mailing Address - Country:US
Mailing Address - Phone:602-923-8500
Mailing Address - Fax:
Practice Address - Street 1:20401 N 73RD ST STE 140
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4148
Practice Address - Country:US
Practice Address - Phone:602-923-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2023-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP7228207XX0005X
FLOS13477207XX0005X
AZ4408207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ094452Medicaid
AZZ190047OtherMEDICARE
TX318004YKTPMedicare PIN