Wolfe, Walter Ray
Wolfe, Walter Ray is an sole proprietor health care provider with primary practice located at 163 River Oaks Dr Ste 204 , Canton MS 39046. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wolfe, Walter Ray can be contacted via phone (601) 855-4881.Contact Information
Primary practice address
163 River Oaks Dr Ste 204
Canton MS 39046
Phone: (601) 855-4881
Fax: (601) 859-5454
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 11096 | Mississippi |
Profile Details
| NPI number | 1073629739 |
|---|---|
| LBN Legal business name | Wolfe, Walter Ray |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 22nd, 2006 |
| Last updated | Jul 18th, 2018 - about 8 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 | 1073629739 | NPPES |
| Mississippi | MEDICAID | 00010644 |
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