Provider Demographics
NPI:1164297743
Name:WALTON, GEORGE HAROLD
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:HAROLD
Last Name:WALTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12143 TWINCREEK DR
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-9793
Mailing Address - Country:US
Mailing Address - Phone:614-843-6073
Mailing Address - Fax:
Practice Address - Street 1:12143 TWINCREEK DR
Practice Address - Street 2:
Practice Address - City:PICKERINGTON
Practice Address - State:OH
Practice Address - Zip Code:43147-9793
Practice Address - Country:US
Practice Address - Phone:614-843-6073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide