Provider Demographics
NPI:1558313312
Name:WALTON, STEPHANIE ANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:ANNE
Last Name:WALTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7237 E SOUTHGATE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2637
Mailing Address - Country:US
Mailing Address - Phone:916-422-6635
Mailing Address - Fax:916-422-6500
Practice Address - Street 1:7237 E SOUTHGATE DR
Practice Address - Street 2:SUITE A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2637
Practice Address - Country:US
Practice Address - Phone:916-422-6635
Practice Address - Fax:916-422-6500
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG070902208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics