Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 20986 | NV |
NPI | 1801250659 |
---|---|
Provider Name | Gregory Trent Walker JR. |
First Address | Reno, NV 89503-4724 |
Second Address | Reno, NV 89503-4724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2016 |
Last Update Date | 20/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
250013578 | (05) | NV |