Individual
WALTER RAY WOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
163 RIVER OAKS DR STE 204, CANTON, MS 39046
(601) 855-4881
(601) 859-5454
Mailing address
163 RIVER OAKS DR STE 204, CANTON, MS 39046-5324
(601) 855-4881
(601) 859-5454
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11096
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00010644
—
MS
Enumeration date
08/22/2006
Last updated
07/18/2018
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