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Individual
KIRK EDWARD WINWARD
Active
Individual
KIRK EDWARD WINWARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
187019 1205
UT
207W00000X
Ophthalmology Physician
187019-1205
UT
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
187019-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010486
MEDICARE
—
01
—
00341000
MEDICAID
ID
01
—
005545102
MEDICARE
—
01
—
005545202
MEDICARE
—
01
—
005584702
MEDICARE
—
01
—
104743400
MEDICAID
WY
01
—
180013350
RAILROAD MEDICARE
—
01
—
870525682
TAX ID #
—
Enumeration date
12/14/2005
Last updated
02/05/2018
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