Healthcare Provider Details

I. General information

NPI: 1023480357
Provider Name (Legal Business Name): ERIC TIMOTHY WALKER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 01/27/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 VICTORIA RD
ASHEVILLE NC
28801-4811
US

IV. Provider business mailing address

PO BOX 602998
CHARLOTTE NC
28260-2998
US

V. Phone/Fax

Practice location:
  • Phone: 828-252-7331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-05879
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number0010-05879
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: