Provider Demographics
NPI:1508498692
Name:WALTON, GEORGE ALBERT III (OD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALBERT
Last Name:WALTON
Suffix:III
Gender:M
Credentials:OD
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Mailing Address - Street 1:278 MASON DR
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-2660
Mailing Address - Country:US
Mailing Address - Phone:717-738-2303
Mailing Address - Fax:717-358-1209
Practice Address - Street 1:1875 HEMPSTEAD RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5671
Practice Address - Country:US
Practice Address - Phone:717-358-1240
Practice Address - Fax:717-358-1209
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOE-007826P152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist