Provider Demographics
NPI:1982668521
Name:ACCLES, WALTER DOUGLAS (PA)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:DOUGLAS
Last Name:ACCLES
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:123 HENDERSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-2868
Mailing Address - Country:US
Mailing Address - Phone:828-257-4730
Mailing Address - Fax:828-257-4738
Practice Address - Street 1:123 HENDERSONVILLE RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-257-4730
Practice Address - Fax:828-257-4738
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC103327363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2763071Medicare ID - Type Unspecified
NCQ38192Medicare UPIN