Individual
WILLIAM WATKINS WALTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4271
(859) 258-4296
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
(859) 258-4271
(859) 258-4296
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
16015
KY
2086S0129X
Vascular Surgery Physician
16015
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36000818
MEDICAID ASC GRP
KY
01
—
37903705
MEDICIAD LAB GRP
KY
01
—
4000501
MEDICARE LAB GRP
KY
05
—
64160153
—
KY
01
—
ASC1019
MEDICARE ASC GRP
KY
01
—
CB5773
RR MEDICARE GRP
GA
Enumeration date
07/25/2006
Last updated
11/02/2007
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