Walters, Gordon Leslie
Walters, Gordon Leslie is an individual health care provider with primary practice located at 818 Saint Sebastian Way Suite 311, Augusta GA 30901-2651. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Walters, Gordon Leslie can be contacted via phone (706) 724-3473.Contact Information
Primary practice address
818 Saint Sebastian Way Suite 311
Augusta GA 30901-2651
Phone: (706) 724-3473
Fax: (706) 724-3493
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 030919 | Georgia |
Profile Details
| NPI number | 1255313789 |
|---|---|
| LBN Legal business name | Walters, Gordon Leslie |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 18th, 2005 |
| Last updated | Jun 24th, 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 | 1255313789 | NPPES |
| Georgia | Other | 024281 | BCBS |
| Georgia | MEDICAID | G30919 | BCBS |
| Georgia | MEDICAID | 000385602A | BCBS |
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