Healthcare Provider Details

I. General information

NPI: 1558312215
Provider Name (Legal Business Name): SARA E WALKER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA ELLEN KAY

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 09/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE HOSPITAL DR
COLUMBIA MO
65212-0001
US

IV. Provider business mailing address

PO BOX 7687
COLUMBIA MO
65205-7687
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-8095
  • Fax: 573-882-1380
Mailing address:
  • Phone: 573-882-2259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMDR7A69
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: