MEDICARE: LATOYA WALTON-TORRENCE 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	207V00000X	Obstetrics & Gynecology Physician	26014	AL

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
2	51520983	OTHER	AL	BXBS OF ALABAMA

General Provider Information

NPI Number	:	1841295458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA WALTON-TORRENCE MD

Provider Business Mailing Address
First Line	:	104 MEDICAL DR
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-6902
Country	:	US
Telephone Number	:	334-671-9445
Fax Number	:	334-836-0059

Provider Business Practice Location Address
First Line	:	104 MEDICAL DR
Second Line	:
City	:	DOTHAN
State	:	AL
Zip	:	36303-6902
Country	:	US
Telephone Number	:	334-671-9445
Fax Number	:	334-836-0059

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	04/15/2010

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