Walton, Kenneth Glen
Walton, Kenneth Glen is an individual health care provider with primary practice located at 1296 Sims St Suite B, Gainesville GA 30501-3850. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Walton, Kenneth Glen can be contacted via phone (770) 534-1856.Contact Information
Primary practice address
1296 Sims St Suite B
Gainesville GA 30501-3850
Phone: (770) 534-1856
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 034490 | Georgia |
Profile Details
| NPI number | 1689783870 |
|---|---|
| LBN Legal business name | Walton, Kenneth Glen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jul 21st, 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 | 1689783870 | NPPES |
| Georgia | MEDICAID | 00660646B |
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