Organization
LARRY R WALTON
Active
Other names
HAND SURGERY CENTER OF SOUTHWEST MI
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY RAYMOND WALTON M.D. (OWNER)
(269) 382-9900
Entity
Organization
Contact information
Practice address
1220 WEST MILHAM AVE, PORTAGE, MI 49024-1206
(269) 382-9900
(269) 382-0700
Mailing address
1220 WEST MILHAM AVE, PORTAGE, MI 49024-1206
(269) 382-9900
(269) 382-0700
Taxonomy
Speciality
Code
Description
License number
State
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
039773
MI
335E00000X
Prosthetic/Orthotic Supplier
039773
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
039279
BCBS
MI
05
—
4079644
—
MI
Enumeration date
06/14/2007
Last updated
08/19/2011
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