Walton, Timothy P

Walton, Timothy P is an individual health care provider with primary practice located at 5471 Dr Martin Luther King Dr , Saint Louis MO 63112-4265. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Pediatrics. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is his primary health care specialty. Walton, Timothy P can be contacted via phone (314) 367-5820.

Contact Information

Primary practice address
5471 Dr Martin Luther King Dr Saint Louis MO 63112-4265
Fax: (314) 623-6326
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Pediatrics 163WP0200X RN133867 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 133867 Missouri

Profile Details

NPI number 1669423976
LBN Legal business name Walton, Timothy P
Credentials MSN, RN, CPNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 12th, 2006
Last updated Jun 30th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669423976 NPPES
Missouri MEDICAID 1669423976

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