MEDICARE: MR. CHARLES B. WALTON MD

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
1	208600000X	Surgery Physician	5802	NV

Other Identifiers

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

General Provider Information

NPI Number	:	1407833395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHARLES B. WALTON MD

Provider Business Mailing Address
First Line	:	10001 S EASTERN AVE STE 310
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3908
Country	:	US
Telephone Number	:	702-914-2420
Fax Number	:	702-914-6653

Provider Business Practice Location Address
First Line	:	10001 S EASTERN AVE STE 310
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3908
Country	:	US
Telephone Number	:	702-914-2420
Fax Number	:	702-914-6653

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	03/24/2023

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Directions to “ MR. CHARLES B. WALTON MD” Practice Location

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