Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | ME51072 | FL |
Y | 207Q00000X | Family Doctor | 51072 | FL |
N | 207QA0401X | Family Doctor - Addiction Medicine | 51072 | FL |
NPI | 1679525463 |
---|---|
Provider Name | Dr. Timothy W Walker |
First Address | Defuniak Springs, FL 32435 |
Second Address | Defuniak Springs, FL 32435 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 07/05/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04656 | BCBS PROVIDER NUMBER (01) | FL |
054964900 | (05) | FL |
059185521 | BCBS PROVIDER NUMBER (01) | AL |
059185566 | BCBS PROVIDER NUMBER (01) | AL |
D46401 | (02) | FL |