Individual
ROBERT WILLIAM WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
136 S 15TH AVE, LAUREL, MS 39440-4124
(601) 428-8428
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 428-8428
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
31916
MS
207N00000X
Dermatology Physician
M-15814
ID
207N00000X
Dermatology Physician
MD2009-0594
NM
Other
Enumeration date
05/02/2007
Last updated
11/29/2023
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