Individual ProviderJon H. WalzFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1000 Ashland Dr, Suite 105, Ashland, KY 41101-7057(606) 327-0077PECOS EnrollmentThis provider is enrolled in PECOS as JON WALZ.Based on the most recent information from CMS, provider Jon H. Walz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1871544817Provider TypeIndividualFull NameWalz, Jon H.TitleDr.CredentialD.O.GenderMaleSole ProprietorYesEnumeration Date5/15/2006Last Updated6/12/2019Contact InformationPractice LocationPractice Address1000 Ashland Dr, Suite 105, Ashland, KY 41101-7057Phone(606) 327-0077Fax(606) 833-9453Mailing LocationMailing Address105 Ponder Ct, Ste 104, Danville, KY 40422-9050Phone(606) 327-0077Fax(606) 833-9453Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense02629KentuckyProvider IdentifiersIDDescriptionIssuerID64990468DescriptionMedicaidIssuerUnlistedKentucky