Provider Demographics
NPI:1972824076
Name:WALSH, JOHN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:WALSH
Suffix:
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:NAVAL HOSPITAL JACKSONVILLE DEPT OF FAMILY
Mailing Address - Street 2:2080 CHILD STREET
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32214-0001
Mailing Address - Country:US
Mailing Address - Phone:907-542-7762
Mailing Address - Fax:
Practice Address - Street 1:115 PURPLE HEART AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19902-5051
Practice Address - Country:US
Practice Address - Phone:302-346-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-13
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101250648207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology