Provider Demographics
NPI:1770729576
Name:WALTON, STEPHEN JOSHUA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:JOSHUA
Last Name:WALTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:1 FREEDOM WAY
Mailing Address - Street 2:PHARMACY DEPT (114)
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904-6258
Mailing Address - Country:US
Mailing Address - Phone:706-733-0188
Mailing Address - Fax:706-823-3968
Practice Address - Street 1:1 FREEDOM WAY
Practice Address - Street 2:PHARMACY DEPT (114)
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904-6258
Practice Address - Country:US
Practice Address - Phone:706-733-0188
Practice Address - Fax:706-823-3968
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARPH024319183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist