Provider Demographics
NPI:1942239207
Name:DAY, WALTER G (MD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:G
Last Name:DAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 S JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-5129
Mailing Address - Country:US
Mailing Address - Phone:325-223-6347
Mailing Address - Fax:325-223-6377
Practice Address - Street 1:3001 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-5129
Practice Address - Country:US
Practice Address - Phone:325-223-6347
Practice Address - Fax:325-223-6377
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141981401Medicaid
TX0057EWOtherBLUE CROSS BLUE SHIELD
TX141981401Medicaid
TXC72157Medicare UPIN