Individual
MR. ALAN S WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
804 AINSWORTH DR, SUITE 103, PRESCOTT, AZ 86301-1624
(928) 771-1011
(928) 771-1332
Mailing address
804 AINSWORTH DR, SUITE 103, PRESCOTT, AZ 86301-1624
(928) 771-1011
(928) 771-1332
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
23577
AZ
2086S0129X
Vascular Surgery Physician
Primary
23577
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5162511
AETNA
AZ
01
—
AZ0766770
BCBS
AZ
Enumeration date
08/24/2006
Last updated
09/11/2025
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