Provider Demographics
NPI:1356426837
Name:WALTON, RHONDA MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:MICHELLE
Last Name:WALTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MONROE PL NE
Mailing Address - Street 2:APT 4304
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4966
Mailing Address - Country:US
Mailing Address - Phone:404-396-2850
Mailing Address - Fax:
Practice Address - Street 1:2000 MONROE PL NE
Practice Address - Street 2:APT 4304
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4966
Practice Address - Country:US
Practice Address - Phone:404-396-2850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049352207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89128W4Medicaid
GA794241084CMedicaid
NC128W4OtherBCBS
NC2294463Medicare ID - Type Unspecified
GA794241084CMedicaid