Individual
MATTHEW TIMOTHY WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 N BLOOMINGTON ST, SUITES B-D, LOWELL, AR 72745-9103
(479) 757-5054
(479) 757-5055
Mailing address
13181 RIDGELINE RD, BENTONVILLE, AR 72712-9190
(479) 273-5766
(479) 273-5766
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2015019923
MO
207Q00000X
Family Medicine Physician
Primary
E-0008
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129927001
—
AR
Enumeration date
06/26/2005
Last updated
04/20/2021
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