W Winston Wilfong, M.D.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

028479 Issued in GA

Practice address

4 Live Oak CT
Moultrie, GA 31768-6783

Phone

(229) 785-2400

Fax

(229) 207-2532

NPI assigned

Feb 26, 2007

Last updated

Nov 8, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1760518773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1539",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317761539",
            "telephone_number": "229-785-2400",
            "fax_number": "229-207-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 LIVE OAK CT",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686783",
            "telephone_number": "229-785-2400",
            "fax_number": "229-207-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILFONG",
        "first_name": "W",
        "middle_name": "WINSTON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-26",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "028479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000391036B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "202G701316",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "102I342359",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Woodwin Michael Weeks, DO
• Marcus Reed Wells, PT
• Patricia G Wells, PT
• Dustin Hunter White
• Carol Cate Whitley, FNP-C
• Heather Wilkes, FNP-C
• William C Byrd Inc (Colquitt Garden Manor)
• William C Byrd Inc (Colquitt Garden Manor)
• Amy J Williams
• Cheau Eugene Williams, MD

• Urology Physician in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Urology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.