Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 70789 | GA |
NPI | 1922250489 |
---|---|
Provider Name | Thomas Juergen Walker |
First Address | Atlanta, GA 30342-4792 |
Second Address | Atlanta, GA 30342-4792 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2008 |
Last Update Date | 01/12/2020 |