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Individual
DR. CLINTON WALLS
Active
Individual
DR. CLINTON WALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
076987
GA
207Q00000X
Family Medicine Physician
Primary
ME134419
FL
390200000X
Student in an Organized Health Care Education/Training Program
21875
FL
Other
Enumeration date
05/28/2015
Last updated
10/18/2022
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