Provider Demographics
NPI:1336128040
Name:GEARY, WALTER THOMAS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:THOMAS
Last Name:GEARY
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3115 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-1103
Mailing Address - Country:US
Mailing Address - Phone:334-395-5372
Mailing Address - Fax:334-395-5343
Practice Address - Street 1:3115 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-1103
Practice Address - Country:US
Practice Address - Phone:334-395-5372
Practice Address - Fax:334-395-5343
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL7259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-02741OtherBLUE CROSS BLUE SHIELD
AL510-02741OtherBLUE CROSS BLUE SHIELD
AL02741Medicare ID - Type Unspecified