Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 28520 | OK |
N | 2080P0214X | Pediatric Pulmonologist | L3864 | TX |
NPI | 1336109966 |
---|---|
Provider Name | Dr. Joseph Walter |
First Address | Tulsa, OK 74136-3347 |
Second Address | Tulsa, OK 74136-7807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 23/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I27551 | (02) | TX |