Healthcare Provider Details

I. General information

NPI: 1700505278
Provider Name (Legal Business Name): WALKWELL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2022
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 E MATTHEWS AVE
JONESBORO AR
72401-3145
US

IV. Provider business mailing address

637 E MATTHEWS AVE
JONESBORO AR
72401-3145
US

V. Phone/Fax

Practice location:
  • Phone: 870-931-3338
  • Fax: 870-935-9084
Mailing address:
  • Phone: 870-931-3338
  • Fax: 870-935-9084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM G COATES JR.
Title or Position: OWNER
Credential: DPM
Phone: 870-931-3338