Individual
JEFFREY THOMAS WALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(770) 219-9000
Mailing address
PO BOX 95460, CLEVELAND, OH 44101-0033
(602) 581-6076
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101273384
VA
2085R0202X
Diagnostic Radiology Physician
2021-02770
NC
2085R0202X
Diagnostic Radiology Physician
39669
SC
2085R0202X
Diagnostic Radiology Physician
Primary
94945
GA
2085R0202X
Diagnostic Radiology Physician
LL39669
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300030405A
—
GA
05
—
396690
—
SC
Enumeration date
06/07/2016
Last updated
01/11/2026
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