Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 01046851A | IN |
N | 208800000X | Urologist | G74666 | CA |
Y | 208800000X | Urologist | MD61157938 | WA |
NPI | 1053301440 |
---|---|
Provider Name | Dr. Carl J Walker |
First Address | Spokane, WA 99202-2902 |
Second Address | Spokane, WA 99202-2902 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 14/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053301440 | NPI (01) | CA |
200152410 | (05) | IN |
G51094 | (02) | IN |