MEDICARE: DR. HEATHER REBECCA WALKER O.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	152W00000X	Optometrist	2236	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

General Provider Information

NPI Number	:	1669428454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER REBECCA WALKER O.D.

Provider Business Mailing Address
First Line	:	90 VERMONT AVE
Second Line	:
City	:	OAK RIDGE
State	:	TN
Zip	:	37830-6474
Country	:	US
Telephone Number	:	865-482-8890
Fax Number	:

Provider Business Practice Location Address
First Line	:	603 HIGHWAY 321 N
Second Line	:	STE 301
City	:	LENOIR CITY
State	:	TN
Zip	:	37771-6575
Country	:	US
Telephone Number	:	865-986-3518
Fax Number	:

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

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	01/11/2013

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