Walter S Medlin MD PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

WALTER S MEDLIN MD PC

Practice address

777 Hospital Way
Pocatello, ID 83201-5175

Phone

(208) 239-2620

NPI assigned

Apr 8, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Walter Scott Edwards Medlin

Title

Owner

Phone

(406) 238-2500

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554681600000",
    "number": "1437612447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1046 E 100 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HOSPITAL WAY",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015175",
            "telephone_number": "208-239-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALTER S MEDLIN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A",
        "authorized_official_last_name": "MEDLIN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "SCOTT EDWARDS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-238-2500"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taryn Walker
• Teresa Rae Walker, LMSW
• Mary Josara Wallber, AUD
• Sydnee Zaytel Wallentine
• Lyndsay Walls, LSW
• Kaitlin Walters
• Dustyn Slade Lee Walton, PT, DPT, ATC
• Amy Rae Wanstrom, LPC
• Ward Clinic PA
• Alexandria Ward

• Surgery Physician in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.