Organization
SAMUEL WALTERS D.O.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL WALTERS D.O (CEO/PHYSICIAN)
(904) 772-2727
Entity
Organization
Contact information
Practice address
6531 103RD ST, JACKSONVILLE, FL 32210-7131
(904) 772-2727
(904) 772-1693
Mailing address
6531 103RD ST, JACKSONVILLE, FL 32210-7131
(904) 772-2727
(904) 772-1693
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
OS8337
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261008600
—
FL
Enumeration date
02/12/2010
Last updated
07/03/2010
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