MEDICARE: KEVIN BURTON WALKER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	43679	TN
2	208VP0014X	Interventional Pain Medicine Physician	27270	SC
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	27270	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093805152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN BURTON WALKER M.D.

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE FL 4
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:	864-522-8603
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 BRENDAN WAY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-3514
Country	:	US
Telephone Number	:	864-522-5030
Fax Number	:	864-522-5035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	05/14/2021

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