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Individual

VICKIE A WALTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD INC

Contact information

Practice address
1313 E HERNDON AVE, STE 205, FRESNO, CA 93720-3306
(559) 435-0311
(559) 435-1708
Mailing address
1313 E HERNDON AVE, STE 205, FRESNO, CA 93720-3306
(559) 435-0311
(559) 435-1708

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
G58237
CA
2084N0400X
Neurology Physician
Primary
G58237
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G582370
CA
Enumeration date
06/14/2005
Last updated
06/22/2010
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