Healthcare Provider Details

I. General information

NPI: 1790298131
Provider Name (Legal Business Name): WALKER WARD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 WASHINGTON AVE
EVANSVILLE IN
47714-0547
US

IV. Provider business mailing address

212 S PETERS RD STE 102
KNOXVILLE TN
37923-5217
US

V. Phone/Fax

Practice location:
  • Phone: 812-476-5577
  • Fax: 423-536-9923
Mailing address:
  • Phone: 276-200-8463
  • Fax: 423-536-9923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: MR. TODD CARL ALLEN
Title or Position: OWNER
Credential: HIS
Phone: 276-200-8463