1225265788 NPI number — DR. PATRICIA LYNNE WALTERS MBCHB,MFOM,MRCGP

Table of content: DR. PATRICIA LYNNE WALTERS MBCHB,MFOM,MRCGP (NPI 1225265788)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225265788 NPI number — DR. PATRICIA LYNNE WALTERS MBCHB,MFOM,MRCGP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALTERS
Provider First Name:
PATRICIA
Provider Middle Name:
LYNNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MBCHB,MFOM,MRCGP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225265788
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
US ARMY AEROMEDICAL RESEARCH LABORATORY
Provider Second Line Business Mailing Address:
FORT RUCKER
Provider Business Mailing Address City Name:
ENTERPRISE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36362-0577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-255-6815
Provider Business Mailing Address Fax Number:
334-255-7798

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
US ARMY AEROMEDICAL RESEARCH LABORATORY
Provider Second Line Business Practice Location Address:
FORT RUCKER
Provider Business Practice Location Address City Name:
ENTERPRISE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36362-0577
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-255-6815
Provider Business Practice Location Address Fax Number:
334-255-7798
Provider Enumeration Date:
06/11/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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