Organization
E WINGO & P COLCHISKI PTR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LINDER EARL WINGO MD (PART-OWNER)
(352) 629-2422
Entity
Organization
Contact information
Practice address
2441 E FORT KING ST BLDG 100, OCALA, FL 34471-2558
(352) 629-2422
(352) 732-0177
Mailing address
2441 E FORT KING ST BLDG 100, OCALA, FL 34471-2558
(352) 629-2422
(352) 732-0177
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1160000001
MEDICARE PTAN
FL
Enumeration date
11/12/2014
Last updated
11/12/2014
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