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NPI Code Detail

MEDICARE: JENNIE WALKER MD

MEDICARE: JENNIE 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
1282NC0060XCritical Access HospitalA73644CA
2207P00000XEmergency Medicine PhysicianA73644CA

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 : 1558371229
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIE WALKER MD
Provider Business Mailing Address
First Line : PO BOX 2485
Second Line :
City : MAMMOTH LAKES
State : CA
Zip : 93546-2485
Country : US
Telephone Number : 760-934-3311
Fax Number : 760-924-4003
Provider Business Practice Location Address
First Line : 85 SIERRA PARK RD
Second Line :
City : MAMMOTH LAKES
State : CA
Zip : 93546-2073
Country : US
Telephone Number : 760-934-3311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 01/09/2021

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