Healthcare Provider Details

I. General information

NPI: 1770849358
Provider Name (Legal Business Name): SCOTT EUGENE WALKER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2012
Last Update Date: 04/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3755 AIRPORT WAY
FAIRBANKS AK
99709-4610
US

IV. Provider business mailing address

863 LANCASTER DR
FAIRBANKS AK
99712-1119
US

V. Phone/Fax

Practice location:
  • Phone: 907-474-1433
  • Fax: 907-474-1447
Mailing address:
  • Phone: 907-455-8040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1327
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: