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General NPI Number Information
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NPI Number | 1588716302
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Entity Type | Individual
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Provider Name | WALTER J PASCHALL MD
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 1611 MOUNT VERNON RD
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City | DUNWOODY
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State | GA
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Zip | 30338-4224
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Country | US
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Telephone | 770-361-5556
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Fax | 770-393-1557
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Provider Business Mailing Address
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Address Line | 222 MORNINGSTAR WAY
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City | BALL GROUND
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State | GA
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Zip | 30107-6214
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Country | US
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Telephone | 770-361-5556
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Fax | 770-393-1557
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 044055
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D2550
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 13376
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License Number State | WV
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