Healthcare Provider Details

I. General information

NPI: 1881632016
Provider Name (Legal Business Name): JOHN R WALKER LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 N TOPEKA ST
WICHITA KS
67202-2406
US

IV. Provider business mailing address

636 N MAIN ST
WICHITA KS
67203-3601
US

V. Phone/Fax

Practice location:
  • Phone: 316-660-7800
  • Fax: 316-264-5425
Mailing address:
  • Phone: 316-660-7600
  • Fax: 316-383-7925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number5854
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: