Provider Demographics
NPI:1992046767
Name:WINGET, LANDON (DO)
Entity type:Individual
Prefix:
First Name:LANDON
Middle Name:
Last Name:WINGET
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 W ORANGE GROVE RD STE 105
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-1196
Mailing Address - Country:US
Mailing Address - Phone:520-230-4900
Mailing Address - Fax:
Practice Address - Street 1:1845 W ORANGE GROVE RD STE 105
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1196
Practice Address - Country:US
Practice Address - Phone:520-230-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-04
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0075622085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology