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Individual

DR. WALTER J PASCHALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1611 MOUNT VERNON RD, DUNWOODY, GA 30338-4224
(770) 361-5556
(770) 393-1557
Mailing address
222 MORNINGSTAR WAY, BALL GROUND, GA 30107-6214
(770) 361-5556
(770) 393-1557

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
044055
GA
207W00000X
Ophthalmology Physician
13376
WV
207W00000X
Ophthalmology Physician
D2550
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
044055
MEDICAL LICENSE
GA
01
13376
PERMANENT LICENSE
WV
01
D2550
TEXAS MEDICAL LICENSE NUMBER
TX
Enumeration date
01/18/2007
Last updated
04/15/2015
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