Individual
DR. GARY RICHARD WALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 GOLDEN WAY, WATKINSVILLE, GA 30677-7712
(706) 612-9401
(706) 612-9420
Mailing address
1150 GOLDEN WAY, WATKINSVILLE, GA 30677-7712
(706) 612-9401
(706) 612-9420
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036630
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000532188E
—
GA
05
—
000532188I
—
GA
Enumeration date
07/14/2005
Last updated
06/21/2022
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