Healthcare Provider Details

I. General information

NPI: 1740261700
Provider Name (Legal Business Name): APRIL C WALTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5955 ZEAMER AVE 673 MDG/MDOS/SGOW
JBER AK
99506-3702
US

IV. Provider business mailing address

5955 ZEAMER AVE 673 MDG/MDOS/SGOW
JBER AK
99506-3702
US

V. Phone/Fax

Practice location:
  • Phone: 907-688-3707
  • Fax:
Mailing address:
  • Phone: 907-688-3707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35070543
License Number StateOH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: