Organization
LAUREL A WALTON DO SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL A WALTON DO (OWNER)
(217) 422-9740
Entity
Organization
Contact information
Practice address
1770 E LAKE SHORE DR, STE 309, DECATUR, IL 62521-3832
(217) 422-9740
(217) 422-7813
Mailing address
1770 E LAKE SHORE DR, STE 309, DECATUR, IL 62521-3832
(217) 422-9740
(217) 422-7813
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036082675
IL
Other
Enumeration date
10/20/2011
Last updated
07/23/2012
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