1rodney Dornell Walton | Blytheville, AR • PECOS Search

1rodney Dornell Walton

Case Manager/Care Coordinator

Other Service Providers

397 Summit St, Blytheville, AR 72315-2241

(870) 740-7639 (870) 532-2600

PECOS Enrollment

Based on the most recent information from CMS, provider 1rodney Dornell Walton does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1538368543
Provider Type
Individual
Full Name
Walton, 1rodney Dornell
Credential
B.S.

Gender
Male
Sole Proprietor
No
Enumeration Date
7/11/2007
Last Updated
7/11/2007

Contact Information

Practice Location

397 Summit St, Blytheville, AR 72315-2241

Unlisted Fax

Mailing Location

1510 Byrum Rd, Blytheville, AR 72315-8033

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer