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Individual

DR. WALTER R CAYCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD, MPH

Contact information

Practice address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 381-5651
Mailing address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 381-5651

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
15242
AZ
207QA0505X
Adult Medicine Physician
15242
AZ
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
15242
AZ
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
35-047652
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
708172
AZ
Enumeration date
02/28/2006
Last updated
01/11/2016
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