Provider Demographics
NPI:1871523589
Name:WINCHELL, ROBERT C (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:WINCHELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1223 CENTER ST
Mailing Address - Street 2:SUITE 25
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1016
Mailing Address - Country:US
Mailing Address - Phone:515-247-8715
Mailing Address - Fax:515-248-8804
Practice Address - Street 1:1223 CENTER ST
Practice Address - Street 2:SUITE 25
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1016
Practice Address - Country:US
Practice Address - Phone:515-247-8715
Practice Address - Fax:515-248-8804
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01981207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0204222Medicaid
IA08006OtherBLUE CROSS/BLUE SHIELD
IA08006OtherBLUE CROSS/BLUE SHIELD
IA0204222Medicaid
IAAW1168168OtherDEA