Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 04356 | KY |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 3178 | TN |
NPI | 1285989368 |
---|---|
Provider Name | Kent L Walker |
First Address | Chicago, IL 60677-6879 |
Second Address | Louisville, KY 40207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2012 |
Last Update Date | 29/10/2020 |