Individual
DR. ALYCIA ANN WALTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
211 US HIGHWAY 421 S, MC KEE, KY 40447-9425
(606) 287-7104
(606) 287-4409
Mailing address
1010 MAIN ST S, MC KEE, KY 40447-7089
(606) 287-7104
(606) 287-4409
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
25MA08433100
NJ
208000000X
Pediatrics Physician
Primary
42455
KY
208000000X
Pediatrics Physician
MD451752
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100087740
—
KY
Enumeration date
09/08/2008
Last updated
07/08/2014
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