Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | MD-070714-L | PA |
NPI | 1003808213 |
---|---|
Provider Name | Joseph Doyle Walton |
First Address | Sellersville, PA 18960-0440 |
Second Address | Sellersville, PA 18960-1571 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2005 |
Last Update Date | 30/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
10127078 | (05) | PA |
I22111 | (02) |