Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | ME39939 | FL |
N | 2080P0210X | Pediatric Nephrologist | ME39939 | FL |
NPI | 1427121250 |
---|---|
Provider Name | Frank C Walker JR. |
First Address | Tallahassee, FL 32312 |
Second Address | Tallahassee, FL 32312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 15/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
066415400 | (05) | FL |
D54623 | (02) |