Healthcare Provider Details

I. General information

NPI: 1295962603
Provider Name (Legal Business Name): MARCUS ANTONIO WALTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FY RD NE
SANDY SPRINGS GA
30342-1606
US

IV. Provider business mailing address

100 PARKVIEW AVE
PORTSMOUTH VA
23704-1932
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8000
  • Fax: 404-303-3759
Mailing address:
  • Phone: 404-374-5867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number87072
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: