Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD462049 | PA |
N | 208000000X | Pediatrician | 2012018921 | MO |
NPI | 1265797617 |
---|---|
Provider Name | Nephi A Walton |
First Address | Danville, PA 17822-4903 |
Second Address | Forty Fort, PA 18704-3859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 17/03/2018 |