Individual
KEITH NESTA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 OGLETHORPE AVE STE 200D, ATHENS, GA 30606-2165
(706) 389-3875
Mailing address
1230 BAXTER ST, ATHENS, GA 30606-3712
(706) 389-3860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13706
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
GA
Other
Enumeration date
04/05/2022
Last updated
10/20/2025
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