Alan S. Walters, M.D., PLLC
Organization Active NPI Vascular Surgery Physician · Prescott, AZ
NPI 1801125802 · NPPES record last updated Feb 5, 2010
Key facts
- NPI
- 1801125802
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- License
- 23577 (AZ)
- Legal business name
- ALAN S. WALTERS, M.D., PLLC
- Practice address
- 804 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1624 - Phone
- (928) 771-1011
- Fax
- (928) 771-1332
- NPI assigned
- Dec 22, 2009
- Organization subpart
- No
Authorized official
- Name
- Natalie Orlando
- Title
- Biller
- Phone
- (928) 636-1810
Practitioners 1
-
Alan S Walters, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100211000113 | AZ | Part B Supplier - Clinic/Group Practice | 4082757190 |
Receives reassigned benefits from 1 practitioner Practice locations: Prescott, AZ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician |
2086S0129X | 23577 | AZ | Yes |
Addresses
Primary practice location
804 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1624
Mailing address
804 Ainsworth Dr
Suite 103
Prescott, AZ 86301-1624
Phone (928) 771-1011
Other providers in Prescott, AZ
- Patricia J Akovenko
- Alaga Health Chronic Care Management LLC
- Alaga Home Health LLC
- Alaga Hospice LLC
- Shayan Alam
- Albert M. Higgins, DDS, PLLC
- Jenna Albert
- Mirandine Alce
- Robert K Alder
- Alejandro Martinez Jr. PLLC
All providers in Prescott, AZ · Vascular Surgery Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.