Provider Demographics
NPI:1275708950
Name:WALTER L CURRY DPM
Entity Type:Organization
Organization Name:WALTER L CURRY DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CURRY
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:815-432-4323
Mailing Address - Street 1:101 W CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:WATSEKA
Mailing Address - State:IL
Mailing Address - Zip Code:60970-1524
Mailing Address - Country:US
Mailing Address - Phone:815-432-4323
Mailing Address - Fax:815-432-4531
Practice Address - Street 1:1103 E GRACE ST
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-3210
Practice Address - Country:US
Practice Address - Phone:219-866-5596
Practice Address - Fax:815-432-4531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000609A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN1277450002Medicare NSC