Individual
KIMROY WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-3635
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 712-3635
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0000
NY
207R00000X
Internal Medicine Physician
MD.41199
AL
Other
Enumeration date
10/27/2016
Last updated
01/07/2021
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