Individual
DR. WALTON W GROTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3396 N FUTRALL DR, SUITE 1, FAYETTEVILLE, AR 72703-4057
(479) 582-1938
(479) 587-0484
Mailing address
3396 N FUTRALL DR, SUITE 1, FAYETTEVILLE, AR 72703-4057
(479) 582-1938
(479) 587-0484
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
R-4003
AR
207L00000X
Anesthesiology Physician
Primary
R-4003
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1163100001
—
AR
Enumeration date
05/26/2006
Last updated
03/23/2011
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