Individual
EVERETTE JOSEPH WALTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
853 N CHURCH ST, SUITE 720C, SPARTANBURG, SC 29303-3098
(864) 560-6419
(864) 560-7498
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
11673
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11673
—
SC
05
—
890598C
—
NC
05
—
GP0859
—
SC
01
—
P00351964
RAILROAD MEDICARE
SC
Enumeration date
11/10/2005
Last updated
03/21/2017
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