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NPI Code Detail

MEDICARE: DOUGLAS A WALSH JR. D.O.

MEDICARE: DOUGLAS A WALSH JR. D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianOS6707FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356347520
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS A WALSH JR. D.O.
Provider Business Mailing Address
First Line : 700 8TH AVE W
Second Line : STE 101
City : PALMETTO
State : FL
Zip : 34221-4737
Country : US
Telephone Number : 941-776-4008
Fax Number : 941-845-4963
Provider Business Practice Location Address
First Line : 919 53RD AVE E
Second Line :
City : BRADENTON
State : FL
Zip : 34203-4801
Country : US
Telephone Number : 941-751-8100
Fax Number : 941-751-8127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 03/24/2017

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