Provider Demographics
NPI:1588739486
Name:WINCHESTER, PATTON & BURGESS, PSC
Entity type:Organization
Organization Name:WINCHESTER, PATTON & BURGESS, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A L
Authorized Official - Last Name:PATTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:606-376-5391
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:WHITLEY CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42653-0099
Mailing Address - Country:US
Mailing Address - Phone:606-376-5391
Mailing Address - Fax:606-376-3326
Practice Address - Street 1:19 MEDICAL LOOP
Practice Address - Street 2:SUITE 3
Practice Address - City:WHITLEY CITY
Practice Address - State:KY
Practice Address - Zip Code:42653
Practice Address - Country:US
Practice Address - Phone:606-376-5391
Practice Address - Fax:606-376-3326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35001825Medicaid
KY2486Medicare PIN
KY35001825Medicaid