Rose, Walter H

Rose, Walter H is an individual health care provider with primary practice located at 122 E Baker St , Indianola MS 38751-2451. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rose, Walter H can be contacted via phone (662) 887-2212.

Contact Information

Primary practice address
122 E Baker St Indianola MS 38751-2451
Fax: (662) 887-1279
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4712 Mississippi

Profile Details

NPI number 1295826196
LBN Legal business name Rose, Walter H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated May 3rd, 2010 - about 16 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 1295826196 NPPES
Mississippi MEDICAID 00114777

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