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Individual

JEFFREY A WALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2 LIVEWELL DR, KENNEBUNK, ME 04043-6762
(207) 467-8898
(207) 467-8969
Mailing address
2 LIVEWELL DR, KENNEBUNK, ME 04043-6762
(207) 467-8898
(207) 467-8969

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1877
ME
207Q00000X
Family Medicine Physician
Primary
DO1877
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
048350
ANTHEM
ME
01
3769958
AETNA
ME
05
431799199
ME
01
9386763
PHCS
ME
01
9759878
CIGNA
ME
Enumeration date
06/28/2006
Last updated
05/21/2026
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