DR. MICHAEL GLEN WALTON (NPI# 1255321881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255321881 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL GLEN WALTON |
| Credential | M.D. |
| Practice Address |
2727 Hearne Ave Suite 300 Shreveport LA 71103-3917 |
| Mailing Address |
Po Box 51008 Shreveport LA 71135-1008 |
| Practice Telephone | 3187989400 |
| Practice Fax Number | 3187983894 |
| Mailing Telephone | 3187989400 |
| Mailing Fax Number | 3187983894 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2017-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD.021647 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 059411101 | 05 | |
| LA | RAILROAD MEDICARE | 060043277 | 01 |
| AR | 132755001 | 05 | |
| LA | 1659525 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730530569 | Michael Walton | Counselor | 7678 Cottonwood Dr Ste C, Jenison, MI 49428 | 2016-06-22 |
| 1326088238 | Michael Eric Walton | Family Medicine | 906 N Main Street, Arlington, OH 45814 | 2006-06-08 |
| 1558820100 | Michael Marcus Walton | Behavior Technician | 1855 2nd St Ste B, Concord, CA 94519-2623 | 2019-03-13 |
| 1699282897 | Michael Gregory Walton | Counselor | 1127 Carnegie Ave, Cleveland, OH 44115-2805 | 2018-01-09 |
| 1912378811 | Michael Walton | Counselor | 803 S Walker St, Burgaw, NC 28425-5001 | 2015-10-18 |
| 1114192028 | Michael Walton | Psychiatry & Neurology | 530 1st Ave, Hcc-10, New York, NY 10016-6402 | 2008-04-23 |
| 1578740437 | Michael J Walton | Occupational Therapist | 2420 Lake Ave, Ashtabula, OH 44004-4954 | 2008-01-23 |
| 1598970006 | Michael G Walton | Dentist | 919 Chambers Blvd, Suite A, Bardstown, KY 40004-2573 | 2007-05-10 |
| 1497732085 | Michael Harold Walton | Emergency Medicine | 2661 County Highway I, Chippewa Falls, WI 54729-5407 | 2005-12-27 |
| Street Address |
2727 HEARNE AVE SUITE 300 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-3917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972043511 | Wk Heart and Vascular Institute Chf Clinic | Internal Medicine | 2727 Hearne Ave, Shreveport, LA 71103-3917 | 2017-03-01 |
| 1831633510 | Kerri Lavigne | Physician Assistant | 2727 Hearne Ave, 300, Shreveport, LA 71103-3917 | 2016-12-14 |
| 1063963890 | Alex Stewart | Nurse Practitioner | 2727 Hearne Ave, Ste 300, Shreveport, LA 71103-3917 | 2016-10-17 |
| 1710366570 | James Clay Harris | Nurse Practitioner | 2727 Hearne Ave, Suite 301, Shreveport, LA 71103-3917 | 2015-05-27 |
| 1487914453 | Amy Myers Brainis | Nurse Practitioner | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2012-05-23 |
| 1871877407 | Cassie James Miller | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2011-09-30 |
| 1952610883 | Shannon Lea Betzing | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2010-09-27 |
| 1134457757 | Kelli Marie Neal | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2009-11-19 |
| 1306173638 | Amanda Mariah Savoie | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2009-11-06 |
| 1609058395 | Angela H Pharr | Physician Assistant | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3931 | 2007-12-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104281476 | White Clover, LLC | Internal Medicine | 8835 Line Ave Ste 400, Shreveport, LA 71106-6730 | 2015-12-30 |
| 1831331842 | Vieux Carre Investments, LLC | Internal Medicine | 8730 Youree Dr Ste B, Shreveport, LA 71115-2518 | 2009-04-06 |
| 1184720393 | Joseph L. Fredi | Internal Medicine | 1811 E Bert Kouns Industrial Loop Ste 210, Shreveport, LA 71105 | 2006-09-15 |
| 1760472419 | Paul Corkran Davis | Internal Medicine | 1453 E Bert Koun Loop Ste 112, Shreveport, LA 71105-6810 | 2005-10-25 |
| 1801886585 | Robert Tate Martin | Internal Medicine | 1811 E Bert Kouns Industrial Loop # 210, Shreveport, LA 71105 | 2005-10-25 |
| 1669472155 | Sanders Fowler Hearne | Internal Medicine | 1811 E Bert Kouns, Suite 100, Shreveport, LA 71115 | 2005-07-26 |
| 1588664080 | William Howard Haynie Jr. | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2005-07-26 |
| 1881127090 | Advanced Cardiovascular Specialists | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2017-04-05 |
| 1972043511 | Wk Heart and Vascular Institute Chf Clinic | Internal Medicine | 2727 Hearne Ave, Shreveport, LA 71103-3917 | 2017-03-01 |
| 1063963189 | Basel Kasabali Md Apmc | Internal Medicine | 1800 Irving Pl, Shreveport, LA 71101-4608 | 2016-10-24 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on DR. MICHAEL GLEN WALTON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.