Individual
DR. KENNETH WILLIAM WALLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
(757) 726-6078
Mailing address
100 EMANCIPATION DR, HAMPTON, VA 23667-0001
(757) 722-9961
(757) 726-6078
Taxonomy
Speciality
Code
Description
License number
State
2081P0004X
Spinal Cord Injury Medicine Physician
Primary
0101040108
VA
2084N0400X
Neurology Physician
0101040108
VA
Other
Enumeration date
04/12/2006
Last updated
09/11/2025
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