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NPI Code Detail

MEDICARE: IAN G WALKER MD

MEDICARE: IAN G WALKER MD
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
1208200000XPlastic Surgery Physician23671CO

Other Identifiers

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

General Provider Information

NPI Number : 1184614315
Entity Type Code : Individual
Provider Name (Legal Business Name) : IAN G WALKER MD
Provider Business Mailing Address
First Line : 6510-A S ACADEMY BLVD
Second Line : #238
City : COLORADO SPRINGS
State : CO
Zip : 80906-8691
Country : US
Telephone Number : 719-632-1818
Fax Number : 719-632-4615
Provider Business Practice Location Address
First Line : 2727 N TEJON ST
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80907-6231
Country : US
Telephone Number : 719-632-1818
Fax Number : 719-632-4615
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 03/19/2014

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