Provider Demographics
NPI:1982690913
Name:WALTON, OLGA V (MD)
Entity Type:Individual
Prefix:
First Name:OLGA
Middle Name:V
Last Name:WALTON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1370
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-837-5571
Mailing Address - Fax:317-837-5580
Practice Address - Street 1:112 HOSPITAL LN
Practice Address - Street 2:SUITE 110
Practice Address - City:DANVILLE
Practice Address - State:IN
Practice Address - Zip Code:46122-1977
Practice Address - Country:US
Practice Address - Phone:317-745-8790
Practice Address - Fax:317-745-8793
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2010-06-08
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Provider Licenses
StateLicense IDTaxonomies
IN01056114A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200381600Medicaid
IN354590GGMedicare PIN
IN200381600Medicaid