NPI 1083770119 · live from the CMS NPI Registry
Walter Ernest Balfour, O.D.
Optometrist in Gallup, NM. National Provider Identifier 1083770119, active.
NPI record
| NPI | 1083770119 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 219 W Coal Ave, Gallup, NM 87301 |
| Practice phone | 505-863-6448 |
| Enumerated | January 1, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 240 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.