Walters, Nathan Frederick
Walters, Nathan Frederick is an individual health care provider with primary practice located at 2800 Cannons Ln Ste 200 , Louisville KY 40205-2164. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Walters, Nathan Frederick can be contacted via phone (502) 454-4885.Contact Information
Primary practice address
2800 Cannons Ln Ste 200
Louisville KY 40205-2164
Phone: (502) 454-4885
Fax: (502) 452-1926
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 8066 | Kentucky |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 8066 | Kentucky |
Profile Details
| NPI number | 1265424907 |
|---|---|
| LBN Legal business name | Walters, Nathan Frederick |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2005 |
| Last updated | Nov 12th, 2018 - about 6 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 | 1265424907 | NPPES |
| Indiana | MEDICAID | 200498320 | |
| Indiana | Other | 000000339061 | |
| Indiana | MEDICAID | 60002789 | |
| Indiana | MEDICAID | 64082688 |
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