Individual
DR. JOHN GORHAM WINSCOTT JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 N STATE STREET, DEPT OF MEDICINE DIVISION OF CARDIOLOGY, JACKSON, MS 39216
(601) 984-5678
Mailing address
2500 N STATE ST, DEPT OF MEDICINE/DIVISION OF CARDIOLOGY, JACKSON, MS 39216-4500
(601) 984-5678
(601) 984-5638
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
18140
MS
207RC0000X
Cardiovascular Disease Physician
18140
MS
207RI0011X
Interventional Cardiology Physician
Primary
18140
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07407323
—
MS
01
—
P01212520
RAILROAD MEDICARE
MS
Enumeration date
10/03/2006
Last updated
08/26/2014
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