LARRY R WALTON NPI 1063440311

NPI Information

  • NPI: 1063440311
  • Provider Name: LARRY R WALTON
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 1220 WEST MILHAM AVE
    PORTAGE, MI
    ZIP 49024
  • Phone: (269) 382-9900

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NPI Details

Larry R Walton is a specialist in Portage, MI. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Larry R Walton NPI is 1063440311. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1220 WEST MILHAM AVE
PORTAGE, MI
ZIP 49024-206
Phone: (269) 382-9900
Fax: (269) 382-0700

The enumeration date for this NPI number is 6/28/2006 and was last updated on 8/11/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1335E00000XProsthetic/Orthotic Supplier039773MICHIGANNo
2174400000XSpecialist039773MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1B47561MEDICARE UPINMICHIGAN
20N56560MEDICARE PINMICHIGAN
3039279OTHERMICHIGANBCBS PROVIDER ID
44079644MEDICAIDMICHIGAN
54495410001MEDICARE NSCMICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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