| Dr David Walt, MD | |
|
810 E Sunflower Rd, Suite 100a, Cleveland, MS 38732-2800 | |
| (662) 843-3606 | |
| (662) 846-1194 |
| Full Name | Dr David Walt |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 810 E Sunflower Rd, Cleveland, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205895448 | NPI | - | NPPES |
| 00115142 | Medicaid | MS | |
| P00232468 | Other | MS | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 09199 (Mississippi) | Primary |
| Entity Name | Bolivar Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063659530 PECOS PAC ID: 6305995895 Enrollment ID: O20090512000274 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Walt, MD 810 E Sunflower Rd, Suite 100a, Cleveland, MS 38732-2800 Ph: (662) 843-3606 | Dr David Walt, MD 810 E Sunflower Rd, Suite 100a, Cleveland, MS 38732-2800 Ph: (662) 843-3606 |
Dr. Nate Brown, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 403 South Davis St, Cleveland, MS 38732 Phone: 662-843-7299 Fax: 662-843-0010 | |
Dr. Don Blackwood, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 803 1st St, Cleveland, MS 38732 Phone: 662-843-2721 | |
Dr. Scott Nelson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 907 E Sunflower Rd, Ste 101, Cleveland, MS 38732 Phone: 662-721-1399 Fax: 662-721-1380 | |
Dr. Charles E Brock Jr., M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 810 E Sunflower Rd, Cleveland, MS 38732 Phone: 662-843-3606 | |
Dr. Degail Jamar Hadley, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 700 E Sunflower Rd, Cleveland, MS 38732 Phone: 662-441-2309 Fax: 662-545-4320 | |
Dr. Paul Warrington, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 810 E Sunflower Rd, Suite 100a, Cleveland, MS 38732 Phone: 662-843-3606 Fax: 662-846-1194 |