Provider Demographics
NPI:1952456303
Name:GASSNER, WALTER F (MD)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:F
Last Name:GASSNER
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 1:12097 OAKVISTA DR
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-6351
Mailing Address - Country:US
Mailing Address - Phone:561-364-2929
Mailing Address - Fax:509-691-1809
Practice Address - Street 1:12097 OAKVISTA DR
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-6351
Practice Address - Country:US
Practice Address - Phone:561-364-2929
Practice Address - Fax:509-691-1809
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME16998208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery