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General NPI Number Information
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NPI Number | 1396521860
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Entity Type | Individual
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Provider Name | KENNETH WELTON WALTERS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2023
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Last Update Date | 08/31/2023
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Provider Practice Location Address
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Address Line | 2246 WINCHESTER RD NE
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City | HUNTSVILLE
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State | AL
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Zip | 35811-6800
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Country | US
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Telephone | 256-851-5807
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Fax |
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Provider Business Mailing Address
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Address Line | 335 J B WALKER RD
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City | NEW MARKET
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State | AL
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Zip | 35761-8327
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Country | US
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Telephone | 256-933-0346
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 23245
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License Number State | AL
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