Walters, Kevin L

Walters, Kevin L is an individual health care provider with primary practice located at 4 Deerwood Ave Nw Tri-County Health Care Wadena Clinic, Wadena MN 56482-1296. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Walters, Kevin L can be contacted via phone (218) 631-1360.

Contact Information

Primary practice address
4 Deerwood Ave Nw Tri-County Health Care Wadena Clinic Wadena MN 56482-1296
Phone: (218) 631-1360
Fax: (218) 631-7507
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 37842 Minnesota

Profile Details

NPI number 1770524035
LBN Legal business name Walters, Kevin L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Jul 22nd, 2015 - about 11 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 1770524035 NPPES
Minnesota Other MN100008 LHS/BANNERHEALTH #
Minnesota Other 768832 LHS/BANNERHEALTH #
Minnesota MEDICAID 890222400 LHS/BANNERHEALTH #
Minnesota Other DA9041015691 LHS/BANNERHEALTH #
Minnesota Other HP19560 LHS/BANNERHEALTH #
Minnesota Other 0106027 LHS/BANNERHEALTH #
Minnesota Other 0106028 LHS/BANNERHEALTH #
Minnesota Other 13136 LHS/BANNERHEALTH #
Minnesota Other 142299 LHS/BANNERHEALTH #
Minnesota Other 0106020 LHS/BANNERHEALTH #
Minnesota Other 21526 LHS/BANNERHEALTH #

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