| Walter L Holton, MD | |
| 
					604 Amanda St, Manteo, NC 27954  | |
| (252) 473-3478 | |
| Not Available | 
| Full Name | Walter L Holton | 
|---|---|
| Gender | Male | 
| Speciality | Family Medicine | 
| Location | 604 Amanda St, Manteo, North Carolina | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1992769178 | NPI | - | NPPES | 
| 01408 | Other | NC | BCBS | 
| 8943465 | Medicaid | NC | |
| 561212625 | Other | TRICARE | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | 19609 (North Carolina) | Primary | 
| Entity Name | Outer Banks Professional Services, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1891050357 PECOS PAC ID: 3173652096 Enrollment ID: O20100602000156  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Walter L Holton, MD Po Box 1045, Manteo, NC 27954 Ph: (252) 473-3478  | Walter L Holton, MD 604 Amanda St, Manteo, NC 27954 Ph: (252) 473-3478  | 
Dr. David Ryan Worthen, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 604 Amanda St, Manteo, NC 27954 Phone: 252-473-3478 Fax: 252-473-3600  | |
Dr. Johnny Lee Farrow, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 715 Us Highway 64, Manteo, NC 27954 Phone: 252-473-2500 Fax: 252-473-1222  | |
Ann C. Sumners, M. D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 604 Amanda St, Manteo, NC 27954 Phone: 252-473-3478 Fax: 252-473-3600  |