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General NPI Number Information
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NPI Number | 1124655923
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Entity Type | Individual
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Provider Name | KELSEY TAYLOR WALTON MD
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Gender | Female
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Dates
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Enumeration Date | 03/24/2020
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 500 W BROADWAY ST
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City | MISSOULA
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State | MT
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Zip | 59802-4008
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Country | US
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Telephone | 406-543-7271
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 94484
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City | SEATTLE
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State | WA
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Zip | 98124-6784
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Country | US
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Telephone | 406-296-8105
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MED-PHYS-LIC-134419
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License Number State | MT
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