Walton, Derek Alan

Walton, Derek Alan is an individual health care provider with primary practice located at 400 E Adams Ave , Riverton WY 82501-4413. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Walton, Derek Alan can be contacted via phone (307) 856-3937.

Contact Information

Primary practice address
400 E Adams Ave Riverton WY 82501-4413
Phone: (307) 856-3937
Fax: (307) 856-1306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 8527006-9934 Utah
Eye and Vision Services Providers / Optometrist 152W00000X 413T Wyoming

Profile Details

NPI number 1295019339
LBN Legal business name Walton, Derek Alan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2011
Last updated Jul 21st, 2022 - about 4 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 1295019339 NPPES
Utah Other U000078885 MEDICARE PTAN

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