Healthcare Provider Details

I. General information

NPI: 1679612253
Provider Name (Legal Business Name): WALKER SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 WALKER VW NW
WALKER MI
49544-9139
US

IV. Provider business mailing address

15933 CLAYTON RD STE 210
BALLWIN MO
63011-2172
US

V. Phone/Fax

Practice location:
  • Phone: 616-588-6570
  • Fax: 616-647-9119
Mailing address:
  • Phone: 616-588-6593
  • Fax: 616-383-0610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ANDREA LYNN PATRICK
Title or Position: MANAGER
Credential:
Phone: 616-588-6593