Walters, Samuel

Walters, Samuel is an individual health care provider with primary practice located at 7451 103Rd St Ste 8 , Jacksonville FL 32210-6788. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Walters, Samuel can be contacted via phone (904) 683-4968.

Contact Information

Primary practice address
7451 103Rd St Ste 8 Jacksonville FL 32210-6788
Phone: (904) 683-4968
Fax: (904) 902-1202
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X OS8337 Florida

Profile Details

NPI number 1336119817
LBN Legal business name Walters, Samuel
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Feb 6th, 2024 - about 2 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 1336119817 NPPES
Florida MEDICAID 261008600

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