Provider Demographics
NPI:1588704050
Name:ABLE, WALTER JR (MD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:
Last Name:ABLE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4253 E WINDSOR LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-9681
Mailing Address - Country:US
Mailing Address - Phone:812-552-1751
Mailing Address - Fax:812-379-4186
Practice Address - Street 1:4253 E WINDSOR LN
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-9681
Practice Address - Country:US
Practice Address - Phone:812-552-1751
Practice Address - Fax:812-379-4186
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01017663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine