Individual
JONATHAN E WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 CHICK ST STE 100, METROPOLIS, IL 62960-2467
(618) 638-1343
(618) 638-1340
Mailing address
28 CHICK ST, METROPOLIS, IL 62960-2467
(618) 524-2176
(618) 524-4131
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036144530
IL
207Q00000X
Family Medicine Physician
45065
KY
Other
Enumeration date
06/23/2009
Last updated
05/10/2018
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