| Doctor Name: | MR. KEVIN WALSH |
| NPI Number: | 1184611733 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 9193 |
| Business Practice Address: | 927 Trettel Ln Cloquet, MN - 557201345 |
| Business Phone Number: | 2188791227 |
| Business Fax Number: | 2188782136 |
| Mailing Address: | 2714 E 2nd St, DULUTH |
| State: | MN |
| Postal Code: | 558121919 |
| Phone Number: | 2187280313 |
| Fax Number: | |
| NPI Enumeration Date: | 09/29/2005 |
| NPI Last Update Date: | 05/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 9193 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |