MEDICARE: DR. JEFFREY F WALKER D.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	122300000X	Dentist	DS027428L	PA

General Provider Information

NPI Number	:	1184773947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY F WALKER D.M.D.

Provider Business Mailing Address
First Line	:	16 GABLE CREST DR
Second Line	:
City	:	PITTSTON TWP
State	:	PA
Zip	:	18640-9663
Country	:	US
Telephone Number	:	570-654-5551
Fax Number	:	570-655-3651

Provider Business Practice Location Address
First Line	:	113 NEW ST
Second Line	:
City	:	HUGHESTOWN
State	:	PA
Zip	:	18640-2148
Country	:	US
Telephone Number	:	570-654-5551
Fax Number	:	570-655-3651

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

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	07/08/2007

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