MEDICARE: REBECCA HUTT WALKER D.O.

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	207R00000X	Internal Medicine Physician	DO1320	TN

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
2	3158460	OTHER	TN	BCBST

General Provider Information

NPI Number	:	1336116193
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA HUTT WALKER D.O.

Provider Business Mailing Address
First Line	:	PO BOX 381587
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38183-1587
Country	:	US
Telephone Number	:	901-761-6157
Fax Number	:	901-761-4145

Provider Business Practice Location Address
First Line	:	6263 POPLAR AVE
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38119-4701
Country	:	US
Telephone Number	:	901-761-6157
Fax Number	:

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

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	11/05/2019

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