Provider Demographics
NPI:1710911920
Name:WALDRON & HOLTON INTERNAL MEDICINE
Entity Type:Organization
Organization Name:WALDRON & HOLTON INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT INTERNIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:WALDRON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:609-953-9000
Mailing Address - Street 1:69 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055
Mailing Address - Country:US
Mailing Address - Phone:609-953-9000
Mailing Address - Fax:609-953-9696
Practice Address - Street 1:69 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055
Practice Address - Country:US
Practice Address - Phone:609-953-9000
Practice Address - Fax:609-953-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty