Individual
LEROY WINFIELD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
163 S TALLAHASSEE ST, HAZLEHURST, GA 31539-6465
(912) 375-7781
(912) 375-4055
Mailing address
PO BOX 277329, ATLANTA, GA 30384-7329
(800) 377-8721
(304) 523-2241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036634
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000646984H
—
GA
01
—
52623802-005
BLUECROSS BLUESHIELD
GA
Enumeration date
01/04/2006
Last updated
09/06/2007
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