| Doctor Name: | WALTER SHORT |
| NPI Number: | 1649295833 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | E1907 |
| Business Practice Address: | 111 S Main St Leachville, AR - 724389097 |
| Business Phone Number: | 8705391115 |
| Business Fax Number: | 8705391125 |
| Mailing Address: | 111 S Main St, P.o. Box 580 LEACHVILLE |
| State: | AR |
| Postal Code: | 724389097 |
| Phone Number: | 8705391115 |
| Fax Number: | 8705391125 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 06/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207PE0004X |
| License Number: | E1907 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | Emergency Medical Services |
| Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |