Austin, Walter Kenneth
Austin, Walter Kenneth is an individual health care provider with primary practice located at 220 J L White Dr Suite 100, Jasper GA 30143-4893. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Austin, Walter Kenneth can be contacted via phone (706) 636-6500.Contact Information
Primary practice address
220 J L White Dr Suite 100
Jasper GA 30143-4893
Phone: (706) 636-6500
Fax: (706) 636-6502
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 047049 | Georgia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 047049 | Georgia |
Profile Details
| NPI number | 1548265838 |
|---|---|
| LBN Legal business name | Austin, Walter Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Jul 31st, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548265838 | NPPES |
| Georgia | MEDICAID | 000818639DEG |
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