Provider Demographics
NPI:1043690985
Name:WINNINGHAM, VICTORIA LYNNETTE (MD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:LYNNETTE
Last Name:WINNINGHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:BELCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15 SHADELL LN
Mailing Address - Street 2:
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-9000
Mailing Address - Country:US
Mailing Address - Phone:501-697-1922
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:BALCONY SUITE 5
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4210
Practice Address - Country:US
Practice Address - Phone:864-455-7895
Practice Address - Fax:864-455-7807
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL38142208000000X
ARE-131982080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics