Individual
MR. RON SHANNON WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
601 S 8TH ST, GRIFFIN, GA 30224-4213
(770) 228-2721
Mailing address
1123 MAPLE DR, GRIFFIN, GA 30224-4938
(404) 425-8409
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
223340
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN223340
GA
Other
Enumeration date
09/08/2021
Last updated
02/13/2023
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