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NPI Code Detail

MEDICARE: GAIL M WALTER MD

MEDICARE: GAIL M WALTER 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
1207Q00000XFamily Medicine Physician19847TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080082031OTHERTNRR MEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1619903192
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAIL M WALTER MD
Provider Business Mailing Address
First Line : 1275 DICK LONAS RD UNIT 101
Second Line :
City : KNOXVILLE
State : TN
Zip : 37909-1383
Country : US
Telephone Number : 865-584-4747
Fax Number : 865-584-1363
Provider Business Practice Location Address
First Line : 1018 HIGHWAY 321 N
Second Line :
City : LENOIR CITY
State : TN
Zip : 37771-6683
Country : US
Telephone Number : 865-986-4450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2006
Last Update Date : 08/17/2020

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Directions to “ GAIL M WALTER MD” Practice Location

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