Individual
BLAINE MICHAEL WINTERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2713 S 74TH ST STE 301, FORT SMITH, AR 72903-5155
(479) 314-4620
(479) 314-4630
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(479) 314-4620
(479) 314-4630
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2019021801
MO
207RP1001X
Pulmonary Disease Physician
2022021013
MO
207RP1001X
Pulmonary Disease Physician
Primary
E-19090
AR
Other
Enumeration date
06/28/2019
Last updated
07/30/2025
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