Individual
JOSEPH A WALTERS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 S VINE ST, BASTROP, LA 71220-4513
(318) 283-3960
(318) 239-8960
Mailing address
PO BOX 293, BASTROP, LA 71221-0293
(318) 283-3620
(318) 239-8620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
203093
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1077038
—
LA
Enumeration date
05/23/2007
Last updated
11/22/2019
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