Basic Information
Provider Information
NPI: 1083665061
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WINKLER
FirstName: CHARLES
MiddleName: F
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7564
Address2:  
City: PADUCAH
State: KY
PostalCode: 420027564
CountryCode: US
TelephoneNumber: 2705540011
FaxNumber: 2705546540
Practice Location
Address1: 100 KIANA CT
Address2:  
City: PADUCAH
State: KY
PostalCode: 420016787
CountryCode: US
TelephoneNumber: 2705540011
FaxNumber: 2705546540
Other Information
ProviderEnumerationDate: 05/13/2006
LastUpdateDate: 01/13/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003XMD0000020188TNN Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
207RH0003X17391KYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
00000032930001KYANTHEM BCBS OF KYOTHER
091060101KYUMWAOTHER
C7071301KYBLUEGRASS FAMILY HEALTHOTHER
06919301KYHEALTH ALLIANCEOTHER
407953801TNBCBS OF TNOTHER
6417391705KY MEDICAID
304808305TN MEDICAID
500795601TNTLC-FAMILYCAREHLTHPLANOTHER
00000023601201TNUNISON HEALTH MEDICARE ADVANTAGEOTHER
02024839901 DEPT OF LABOROTHER
17957001KYHEALTH LINKOTHER
296801KYCHA HEALTHOTHER


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