Wing Surgical PA

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

602761 Issued in FL

Legal business name

WING SURGICAL PA

Practice address

309 N Mangoustine Ave
Sanford, FL 32771-1098

Phone

(407) 322-7761

Fax

(407) 322-7763

NPI assigned

May 4, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Meldrum Wing, M.D.

Title

Physician

Phone

(407) 322-7761

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1871811646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 N MANGOUSTINE AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711098",
            "telephone_number": "407-322-7761",
            "fax_number": "407-322-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 N MANGOUSTINE AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711098",
            "telephone_number": "407-322-7761",
            "fax_number": "407-322-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WING SURGICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-04",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "WING",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "MELDRUM",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "407-322-7761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "FL",
            "license": "602761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Willis, CRNA
• Rebecca Willoughby
• Aundraya Wilson, PTA
• Wesley Wilson, PA-C
• Sheena Wimberly, LPN
• Brian Wisherd, MA, CCC-SLP
• James E Witherspoon IV, CCEMT-P, CCHW
• Austin B Witnauer, DPT
• Jenna Witt Wilkins, LMT
• Jennifer Mary Wixted, LCSW, CAP

• Plastic and Reconstructive Surgery Physician in Sanford, FL
• Providers in Sanford, FL by specialty
• Plastic and Reconstructive Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.