Organization
JOHN A WALSH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ALAN WALSH MD (PRESIDENT)
(386) 328-0245
Entity
Organization
Contact information
Practice address
14 OFFICE PARK DR STE 7, PALM COAST, FL 32137-3830
(386) 302-5064
(386) 302-5093
Mailing address
PO BOX 17021, BELFAST, ME 04915-4065
(386) 302-5064
(386) 302-5093
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME78805
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110996800
—
FL
01
—
Q0466
MEDICARE
FL
Enumeration date
05/25/2006
Last updated
07/29/2021
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