Organization
WALZ FAMILY MEDICINE, P.S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON H. WALZ JR. D.O. (PHYSICIAN)
(606) 327-0077
Entity
Organization
Contact information
Practice address
1000 ASHLAND DR, SUITE 105, ASHLAND, KY 41101-7084
(606) 327-0077
(606) 833-9453
Mailing address
PO BOX 936, FLATWOODS, KY 41139-0936
(606) 327-0077
(606) 833-9453
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02629
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64990468
—
KY
Enumeration date
07/23/2006
Last updated
03/19/2008
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