Grote, Walton W

Grote, Walton W is an individual health care provider with primary practice located at 3396 N Futrall Dr Suite 1, Fayetteville AR 72703-4057. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Grote, Walton W can be contacted via phone (479) 582-1938.

Contact Information

Primary practice address
3396 N Futrall Dr Suite 1 Fayetteville AR 72703-4057
Phone: (479) 582-1938
Fax: (479) 587-0484
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X R-4003 Arkansas
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X R-4003 Arkansas

Profile Details

NPI number 1053367219
LBN Legal business name Grote, Walton W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Mar 23rd, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053367219 NPPES
Arkansas MEDICAID 1163100001

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