Provider Demographics
NPI:1326078841
Name:BRITT, WALTER KEVIN (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:KEVIN
Last Name:BRITT
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 1:1801 CLIFTY DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-1627
Mailing Address - Country:US
Mailing Address - Phone:812-265-6800
Mailing Address - Fax:812-265-1470
Practice Address - Street 1:1801 CLIFTY DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-1627
Practice Address - Country:US
Practice Address - Phone:812-265-6800
Practice Address - Fax:812-265-1470
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01050103207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN412315POtherSIHO
5123753OtherAETNA
IN000000111715OtherANTHEM BCBS
KY65928533Medicaid
080143450OtherMEDICARE RAILROAD
IN200180150AMedicaid
IN000000111715OtherANTHEM BCBS
IN412315POtherSIHO
259400Medicare PIN
IN200180150AMedicaid