Provider Demographics
NPI:1003808213
Name:WALTON, JOSEPH DOYLE (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DOYLE
Last Name:WALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 440
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-0440
Mailing Address - Country:US
Mailing Address - Phone:215-257-9500
Mailing Address - Fax:215-257-3578
Practice Address - Street 1:670 LAWN AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1571
Practice Address - Country:US
Practice Address - Phone:215-257-9500
Practice Address - Fax:215-257-3578
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-070714-L207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10127078Medicaid
I22111Medicare UPIN
PA10127078Medicaid
PALUG086090Medicare PIN