Individual
ROBERT WADE WINEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
969 LAKELAND DR, JACKSON, MS 39216-4606
(877) 406-2916
(601) 682-7909
Mailing address
PO BOX 55769, JACKSON, MS 39296-5769
(601) 200-6162
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101237841
VA
2085R0202X
Diagnostic Radiology Physician
Primary
20544
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00752697
RAILROAD MEDICARE
—
Enumeration date
05/21/2007
Last updated
02/10/2017
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