MEDICARE: WILLIAM K WALSH M.D.

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	207RH0003X	Hematology & Oncology Physician	18137	MS
2	207RH0003X	Hematology & Oncology Physician	15925	TN

General Provider Information

NPI Number	:	1982602785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM K WALSH M.D.

Provider Business Mailing Address
First Line	:	965 RIDGE LAKE BLVD STE 103
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-9446
Country	:	US
Telephone Number	:
Fax Number	:	901-227-8591

Provider Business Practice Location Address
First Line	:	2996 KATE BOND RD
Second Line	:	SUITE 207
City	:	BARTLETT
State	:	TN
Zip	:	38133-4030
Country	:	US
Telephone Number	:	901-379-0703
Fax Number	:	901-379-0532

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	06/23/2021

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