Provider Demographics
NPI:1952497737
Name:WALTON, MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:WALTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 NW SAMARITAN DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-4744
Mailing Address - Country:US
Mailing Address - Phone:541-768-6119
Mailing Address - Fax:
Practice Address - Street 1:3521 NW SAMARITAN DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-4744
Practice Address - Country:US
Practice Address - Phone:541-768-6119
Practice Address - Fax:541-768-6120
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD29243207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology