Provider Demographics
NPI:1942450374
Name:WALSH, JANET LEIGH (OD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:LEIGH
Last Name:WALSH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 RALEIGH LAGRANGE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-5243
Mailing Address - Country:US
Mailing Address - Phone:901-382-3937
Mailing Address - Fax:
Practice Address - Street 1:5070 RALEIGH LAGRANGE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-5243
Practice Address - Country:US
Practice Address - Phone:901-382-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT1266152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist