MEDICARE: WALTERS SURGICAL ASSOC PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1942265301
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WALTERS SURGICAL ASSOC PA

Provider Business Mailing Address
First Line	:	220 JEFFERSON ST
Second Line	:
City	:	WHITEVILLE
State	:	NC
Zip	:	28472-3416
Country	:	US
Telephone Number	:	910-642-3214
Fax Number	:	910-642-2085

Provider Business Practice Location Address
First Line	:	220 JEFFERSON ST
Second Line	:
City	:	WHITEVILLE
State	:	NC
Zip	:	28472-3416
Country	:	US
Telephone Number	:	910-642-3214
Fax Number	:	910-642-2085

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SHIRREL RHODES
Credential	:
Telephone Number	:	910-642-3214

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	03/16/2010

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Directions to “WALTERS SURGICAL ASSOC PA ” Practice Location

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