Individual
JOHN EDMOND WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
402 MEMORIAL DRIVE EXTENSION, GREER, SC 29651
(864) 877-0779
(864) 877-7801
Mailing address
402 MEMORIAL DRIVE EXTENSION, GREER, SC 29651
(864) 877-0779
(864) 877-7801
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
6530
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065306
—
SC
01
—
89133WF
MEDICAID
NC
Enumeration date
10/12/2006
Last updated
11/05/2007
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