Provider Demographics
NPI:1386498285
Name:WALTON, JOSHUA M (BFA)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:M
Last Name:WALTON
Suffix:
Gender:M
Credentials:BFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-0647
Mailing Address - Country:US
Mailing Address - Phone:802-479-4055
Mailing Address - Fax:802-661-5699
Practice Address - Street 1:23 SUMMER ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-3741
Practice Address - Country:US
Practice Address - Phone:802-479-4055
Practice Address - Fax:802-661-5699
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0136344390200000X
172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No172V00000XOther Service ProvidersCommunity Health Worker