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Individual

DR. WILLIAM J WALTERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
923 E CENTRAL AVE, LA FOLLETTE, TN 37766-2768
(423) 907-1200
Mailing address
5220 BELFORT RD STE 130, JACKSONVILLE, FL 32256-6017
(904) 446-3451
(904) 446-3013

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11726
TN
208D00000X
General Practice Physician
11726
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3184458
TN
Enumeration date
03/08/2006
Last updated
07/10/2015
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