Provider Demographics
NPI:1477547800
Name:WALTON, RUTH E (MD)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:E
Last Name:WALTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:201 S MAIN ST
Mailing Address - Street 2:STE 3400
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2932
Mailing Address - Country:US
Mailing Address - Phone:434-799-4588
Mailing Address - Fax:434-799-4408
Practice Address - Street 1:3300 ACADEMY AVE
Practice Address - Street 2:ACADEMY CROSSING MEDICAL PLAZA
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-3205
Practice Address - Country:US
Practice Address - Phone:757-483-6404
Practice Address - Fax:757-483-0737
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-31
Last Update Date:2018-11-01
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Provider Licenses
StateLicense IDTaxonomies
VA01010581122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010139716Medicaid
VA180068OtherANTHEM
007671C77Medicare ID - Type Unspecified