Walls, Larry D
Walls, Larry D is an individual health care provider with primary practice located at 1600 N Grand Avenue Suite 150, Pueblo CO 81003-2755. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Walls, Larry D can be contacted via phone (719) 595-7700.Contact Information
Primary practice address
1600 N Grand Avenue Suite 150
Pueblo CO 81003-2755
Phone: (719) 595-7700
Fax: (719) 595-7719
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 16515 | Colorado |
Profile Details
| NPI number | 1124086426 |
|---|---|
| LBN Legal business name | Walls, Larry D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2006 |
| Last updated | Sep 11th, 2012 - about 13 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 | 1124086426 | NPPES |
| Colorado | MEDICAID | 01165158 |
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