Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 054523 | GA |
N | 207T00000X | Neurosurgeon | 2000149847 | MO |
Y | 207T00000X | Neurosurgeon | MD25770 | OR |
NPI | 1063414803 |
---|---|
Provider Name | David Howard Walker |
First Address | Medford, OR 97504-8475 |
Second Address | Medford, OR 97504-8475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 06/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278046 | (05) | OR |
I12739 | (02) |