Provider Demographics
NPI:1851376164
Name:JOYNER, WALTON KITCHIN JR (MD)
Entity Type:Individual
Prefix:
First Name:WALTON
Middle Name:KITCHIN
Last Name:JOYNER
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 1:3900 BROWNING PLACE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6530
Mailing Address - Country:US
Mailing Address - Phone:919-787-2758
Mailing Address - Fax:919-787-2988
Practice Address - Street 1:3900 BROWNING PLACE
Practice Address - Street 2:SUITE 200
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6530
Practice Address - Country:US
Practice Address - Phone:919-787-2758
Practice Address - Fax:919-787-2988
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39152207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
47568OtherBLUE CROSS BLUE SHIELD
NC8947568Medicaid
NC8947568Medicaid
NC2149639DMedicare PIN